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Pre-transfusion Testing in Women with High Bleeding Risk Requiring Prolonged Hospitalization

  • Theresa Nester
  • Katherine L. Eastwood
Chapter

Abstract

Pregnant women with repeat bleeding episodes due to placenta previa may be admitted for hospital bedrest. If the clinician requests that crossmatched red cells be kept on hand “at all times,” this will require a blood draw for pre-transfusion testing every 3 days. Limited data suggests that these patients have a low risk of new red cell alloantibody formation, and that the majority do not need transfused while on bedrest. If this is the case, then phlebotomy for pre-transfusion testing every 3 days is excessive, and places the patient at unnecessary risk of losing venous access. Hospitals that admit pregnant patients for prolonged bedrest should work to develop protocols between the obstetrical and transfusion service, such that pre-transfusion testing is reduced when possible.

Keywords

Placenta previa Bedrest Antenatal bleeding 

References

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    Rothenberg JM, Weirermiller B, Dirig K, et al. Is a third-trimester antibody screen in Rh+ women necessary? Am J Manag Care. 1999;5(9):1145–50.PubMedGoogle Scholar
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    Nester TA, Eastwood K. Toward optimal pre-transfusion testing protocols in high risk obstetrical patients. Transfusion. 2014;54:S349.Google Scholar
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    Alcorn K, Eastwood K, Nester T. Extending the crossmatch validity date for high risk antenatal patients on bedrest. Transfusion. 2017;57(S3):52A.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Laboratory MedicineUniversity of Washington Medical CenterSeattleUSA
  2. 2.Integrated Transfusion Service Laboratories, Bloodworks NorthwestSeattleUSA
  3. 3.Obstetrix Medical Group of Washington/ Swedish Medical CenterSeattleUSA

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