Xie Juan, Ling Yu, Zhou Xiaoyu
Department of Blood Transfusion, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
Department of Blood Transfusion, Nanjing Women and Children's Healthcare Hospital, Women's Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
AJP Rep. 2024 Aug 30;14(3):e208-e214. doi: 10.1055/a-2388-3298. eCollection 2024 Jul.
The primary purpose of this study was to assess the practicability of predeposit autologous blood donation (PABD) in the practice of Rh(D)-negative pregnant women. A cohort of 405 Rh(D)-negative pregnant women who had a delivery in the comprehensive tertiary hospital in Nanjing was analyzed retrospectively, over 10 years. After PABD, 203 women experienced a slight drop in mean hemoglobin of 5.32 ± 0.5 g/L (PABD-associated anemia was not featured in our study). Thirteen women who received allogeneic blood might benefit from PABD practically. PABD is applicable for Rh(D)-negative pregnant women, as it ensures the availability of the patient's blood in the event of perinatal hemorrhage, thus minimizing the need for transfusion from external sources. Despite the autologous blood reinfusion of low proportion, PABD could still serve as an alternative when allogeneic blood resources are scarce. However, one challenge in the future is to identify candidates who may benefit most from PABD. Also, more attention is needed to raise awareness of patient blood management. Recommended strategies include early screening and treatment of anemia, hemostasis promotion, and blood loss reduction. Replacement of allogeneic transfusion with autotransfusion could be referred to where feasible. We believe that PABD still has a promising potential for application in Rh(D)-negative pregnant women.
本研究的主要目的是评估预存式自体输血(PABD)在Rh(D)阴性孕妇中的实用性。回顾性分析了南京一家综合性三级医院10多年间分娩的405例Rh(D)阴性孕妇队列。进行PABD后,203名女性的平均血红蛋白略有下降,为5.32±0.5g/L(本研究未出现PABD相关贫血)。13名接受异体输血的女性可能在实际中从PABD中获益。PABD适用于Rh(D)阴性孕妇,因为它能确保在围产期出血时患者有可用血液,从而最大限度减少外部输血需求。尽管自体血回输比例较低,但在异体血资源稀缺时,PABD仍可作为一种替代方法。然而,未来的一个挑战是确定可能从PABD中获益最大的候选人。此外,还需要更多关注以提高患者血液管理意识。推荐的策略包括早期贫血筛查与治疗、促进止血和减少失血。在可行的情况下可考虑用自体输血替代异体输血。我们认为PABD在Rh(D)阴性孕妇中的应用仍有广阔前景。