Definitions of anaemia in pregnancy (RCOG 2015, JPAC):
First trimester : Hb < 110g/L
Second/third trimester: Hb < 105g/L
Post-partum: Hb < 100g/L
Screen for anaemia at booking and 28 weeks.
For all anaemic pregnant women, give a trial of oral iron (100mg-200mg elemental iron / day), and check for Hb rise at 2 weeks.
Intra-operative cell salvage is recommended for all pregnant women where blood loss is expected to induce anaemia or is >20% of the estimated blood volume.
RhD prophylaxis for ICOS in RhD-negative women requires a minimum dose of 1500IU anti-D immune globulin following reinfusion of salvaged cells.
Tests of FMH are required after 30-40 minutes following reinfusion.
Blood products should be:
ABO/RhD compatible.
Kellnegative (unless the woman is known to be K positive).
If there are any alloantibodies, the blood must be negative for the corresponding antigen.
CMV seronegative, unless blood is required emergently an no CMV-negative units are available.
In extreme emergencies, O- blood should be given, although it may be incompatible with other red cell alloantibodies.
For pregnant women in the UK, group and screen samples are sent at booking and at 28 weeks.
For women at high risk of emergency transfusion (e.g. placenta praevia), GXM samples should be sent weekly to exclude or identify new alloantibody formation (RCOG 2015).
Leave A Comment