Predeposit Autologous Blood Donation in Rh(D)-Negative Pregnant Women: A Single-Center Study

Abstract

Objective 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. Materials and Methods 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. Results 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. Conclusion 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.

Keywords: gestational anemia; patient blood management; postpartum hemorrhage; predeposit autologous blood donation.

Fig. 1

Flowchart for the patient inclusion and exclusion in this study. PABD, predeposit autologous blood donation.

Fig. 2

Changes in mean Hb values before PABD and before delivery in 203 patients. Hb, hemoglobin; ns, not significant; PABD, predeposit autologous blood donation.

Fig. 3

Details of patients who received transfusion among the PABD group ( n  = 203) and non-PABD group ( n  = 141). PABD, predeposit autologous blood donation; PBL, postpartum blood loss.

Fig. 4

Distribution of hemoglobin value before delivery among four groups. Hb, hemoglobin.

Fig. 5

Distribution of postpartum blood loss among four groups. Group 1: autologous blood transfusion group ( n  = 43). Group 2: patients who met the criteria for PABD but did not undergo and required no transfusion ( n  = 128). Group 3: patients who met the criteria for PABD but did not undergo and need transfusion ( n  = 13). Group 4: patients who were ineligible for PABD and received allogeneic blood transfusion ( n  = 26). PABD, predeposit autologous blood donation.