Assessing The Feasibility And Safety Of Preoperative Autologous Blood Donation On Pregnant Patients

Objective To assess the feasibility and safety of preoperative autologous blood donation (PABD) on pregnant patients. Methods According to the risk for postpartum hemorrhage, the cases were classified into three groups:low, medium and high. A prospective observational study was conducted among women who met the inclusion criteria and gave birth at Nanjing Drum Tower Hospital, between January and December 2013. After delivery, data on blood donation procedures, obstetric outcomes and blood transfusions was collected for analysis. Results 92 patients were enrolled during the study period and performed 115 blood donations. The indications of PABD are pregnant women who are at high risk for massive blood loss during delivery or have blood difficult to match for transfusion (rare blood type)。The median volumes of donated blood were 300mL,300mL and 400mL in different groups, respectively. There was no significant difference among the HR, SBP and SpO2 during blood donation procedures (p> 0.05) except for the fall of diastolic blood pressure by an average of 3.4mmHg (p< 0.05) 5min after the blood collection, which recovered later. There were no cases of non-reassuring fetal heart rate patterns. Although the levels of HB and HCT after donation were less than those before donation (p<0.05), and recovered before delivery in PABD cases who donated once (p>0.05) which was similar to the cases who donated twice,the changes of HB and HCT were not significant in the second before and after donation (p> 0.05). The median volumes of postpartum hemorrhage are 821.6 mL (range,120-8400) mL Homologous blood transfusion was performed for 5 in all group and in no cases the volume of blood loss was< 2000mL. All of the newborns survived without asphyxia and there was no perinatal death. Conclusion The whole blood can be provided for maternals by PABD timely.Under strict management, PABD is feasible and safe for pregnant women and their infants. The indications of PABD are pregnant patients who are at high risk for massive blood loss during delivery or have blood difficult to match for transfusion (rare blood type).