Autologous blood transfusion in the third trimester of pregnancy

Lee, Jae Sung; Lee, Sung Hwan; Park, Cheol Hoon; Kim, Yong Wook; Ro, Duck Yeong; Kim, Tae Eung; Jung, Jae Keun; Lee, Je Hoon

Abstract

OBJECTIVE
Preoperative autologous blood donation aims at avoiding the risks associated with exposure to allogenic blood and transfusion related diseases such as AIDS and hepatitis. While its use is frequent in adult patients with elective surgery, it is still uncommon in pregnant women because its safety has not been established for mother and fetus. The aim of this study is to determine the safety and utility of autologous blood donation in the third trimester of pregnancy.
METHODS
In this study, sixteen pregnant women with placenta previa, Rh negative or huge myoma underwent 24 phlebotomies according to an autologous transfusion program. Phlebotomies were performed at an average gestational age of 36+4 weeks (range 34-41 weeks). Maternal vital sign and fetal heart rate were monitored before, during and after phlebotomy. Hematocrit was statistically evaluated by paired t-test.
RESULTS
During the phlebotomy, there was no remarkable change in fetal heart rate except one case with temporary fetal tachycardia. Furthermore, changes in mean maternal diastolic blood pressure and pulse rate were not noted except one case with mild dizziness and diaphoresis. Change in mean maternal hematocrit between the initial donation and admission day for delivery was not statistically significant (P>0.05). The average interval from last donation to delivery was 9.8 day (2-20 day). Fetal outcomes were good in all cases.
CONCLUSION
We concluded that preoperative autologous blood donation in pregnant woman in third trimester is safe for mother and fetus. So, if pregnant woman do not want to receive allogeneic transfusion, autologous blood transfusion might be the alternative method.