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前置胎盘伴自体输血所致产前出血:一例报告

Antepartum hemorrhage due to placenta previa with autologous transfusion: A case report.

作者信息

Kaukaba Rizki Dunniroh, Permana Septian Adi, Hananto Arif Zuhal Amin, Muhammad Faizal

机构信息

Anesthesiology and Intensive Care Department, RSUD Dr. Moewardi, Faculty of Medicine, Universitas Sebelas Maret, Surakarta 57126, Indonesia.

Anesthesiology and Intensive Care Department, RSUD Dr. Moewardi, Faculty of Medicine, Universitas Sebelas Maret, Surakarta 57126, Indonesia.

出版信息

Int J Surg Case Rep. 2024 Aug;121:109999. doi: 10.1016/j.ijscr.2024.109999. Epub 2024 Jul 4.

Abstract

INTRODUCTION AND IMPORTANCE

Bleeding during pregnancy or during childbirth can cause significant morbidity and mortality for the mother and baby, this can be overcome by performing a caesarean section (C-section) and blood transfusions. Although blood transfusions can save lives, there is a risk such as transfusion reactions, transmission of infection, and anaphylaxis. Giving autologous blood transfusion can reduce the risk of these events. This case report aims to investigate the advantages of autologous blood transfusion in managing the patient's hemodynamic status compared to homologous blood transfusion.

CASE PRESENTATION

A 21-year-old female (G2P1A0) with antepartum hemorrhage (APH) due to placenta previa underwent emergency C-section with intrauterine device installation and hysterectomy. The patient received an autologous transfusion to improving the hematocrits and hemoglobin within 30 min. Autologous transfusion provided routine postoperative hemodynamics, electrolytes, and blood stability. However, it could not completely replace homologous transfusion.

CLINICAL DISCUSSION

Autologous transfusion reduces transfusion response, infection risk, and immunosuppression. Consequently, it reduces the need for allogenic blood supplies and enables safer transfusion for people with rare blood types and various auto-antibodies.

CONCLUSION

Autologous transfusions may provide better outcomes in C-section surgery for APH patients due to placenta previa. Thus, we recommend the use of autologous over homologous transfusion. Further research is required to compare them to a large population.

摘要

引言与重要性

孕期或分娩期间出血可导致母婴出现严重的发病率和死亡率,这可通过剖宫产(剖腹产)和输血来克服。尽管输血可以挽救生命,但存在诸如输血反应、感染传播和过敏反应等风险。进行自体输血可以降低这些事件的风险。本病例报告旨在研究与异体输血相比,自体输血在管理患者血流动力学状态方面的优势。

病例介绍

一名21岁女性(G2P1A0)因前置胎盘导致产前出血,接受了紧急剖腹产手术,并安装了宫内节育器及进行了子宫切除术。患者在30分钟内接受了自体输血以提高血细胞比容和血红蛋白水平。自体输血使术后的血流动力学、电解质和血液保持稳定。然而,它不能完全替代异体输血。

临床讨论

自体输血可降低输血反应、感染风险和免疫抑制。因此,它减少了对异体血液供应的需求,并使稀有血型和各种自身抗体患者的输血更安全。

结论

对于因前置胎盘导致产前出血的患者,自体输血在剖腹产手术中可能会带来更好的结果。因此,我们建议使用自体输血而非异体输血。需要进一步研究以在大量人群中对它们进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9178/11298588/d12cddc9ce1d/gr1.jpg

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