[Programmed autologous transfusion in obstetrics. Blood samples in 100 patients in the last month of pregnancy].

OBJECTIVES

Evaluation (usefulness and safety) of programmed autologous transfusion in obstetrics. SITE. Blood Transfusion Centre, Hôpital Louis-Mourier, F 92700 Colombes.

PATIENTS

Prospective study of 150 patients for whom blood withdrawal was planned during the last month of pregnancy. Entry criteria were either a risk of haemorrhage or persistent patient request.

PROTOCOL

Two withdrawals were planned during the last month of pregnancy at the out-patient clinic at a one-week interval. The autologous units were transfused per-partum in case of haemorrhage and/or post-partum in case of anaemia.

RESULTS

One hundred pregnant women entered the protocol (43 had a risk of haemorrhage). Both preplanned withdrawals were made in 60 of these patients. Per-partum transfusions were necessary in only 7 patients including 4/43 with a risk factor (9%) and 3/57 with no risk factor (5%). Post-partum transfusions were made in 22 other patients. Consequently, 117 of the 160 units collected were not used (73%).

CONCLUSION

Despite good tolerance (5% incidence) due to the known problems in evaluating the risk of haemorrhage and the small percentage of patients without risk factors who were transfused per-partum, we have decided to reserve this protocol for patients with an authentically identified risk of haemorrhage (placenta praevia, cesarean section, uterine scar tissue).