Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Division of Hematology/Oncology, William Beaumont Army Medical Center, El Paso, TX.
Am J Obstet Gynecol. 2018 Feb;218(2):219.e1-219.e4. doi: 10.1016/j.ajog.2017.10.023. Epub 2017 Oct 31.
The US Department of Defense recently made the decision to open direct ground combat roles to women. Blood product transfusion is an essential component of the US Military guidelines for tactical combat casualty care and damage control resuscitation, but blood transfusion carries with it the specific side effect of alloimmunization-a uniquely significant side effect for young women who may desire subsequent pregnancies. Presently to be considered are the changes that may need to be made to blood transfusion in the setting of battlefield medicine to optimally care for combat-injured women, as a majority of the existing data regarding the risks of transfusion in the trauma setting involve predominantly men. This article delves into the possibility of a new cohort of women at risk for hemolytic disease of the fetus and newborn, the need for women's health professionals to appropriately counsel women considering serving in direct ground combat roles about this specific risk, and the appropriate steps that should be considered to provide these women optimal medical care.
美国国防部最近决定向女性开放直接地面作战角色。血液制品输注是美国军事战术战斗伤员救治和损伤控制性复苏指南的重要组成部分，但输血会带来同种免疫的特定副作用——对于可能希望随后怀孕的年轻女性来说，这是一种非常重要的副作用。目前需要考虑的是，可能需要对战场医学中的输血进行哪些改变，以最佳地照顾受伤的女战士，因为大多数关于创伤环境中输血风险的数据主要涉及男性。本文探讨了一个新的风险群体——胎儿和新生儿溶血病的女性，需要妇女健康专业人员向考虑担任直接地面作战角色的女性提供关于这一特定风险的适当咨询，以及应考虑采取哪些适当步骤为这些女性提供最佳医疗护理。
