A REAPPRAISAL OF THE NEED FOR AUTOLOGOUS BLOOD DONATION IN THE OBSTETRIC PATIENT

There has been recent interest in autologous blood donation in obstetric patients, but little attention has been paid to whether such programs are needed or whether the patients that will require transfusion can be accurately predicted. At the University of California San Diego Medical Center from July 1 to Dec. 31, 1988, there were 2265 deliveries; 13 women (0.57%) received blood transfusions. Traditionally accepted risk factors were identified in 251 patients, with only four (1.6%) requiring transfusion. Among the 150 patients delivered by repeat cesarean section, only one (0.7%) required blood. One of 27 (3.7%) multiple gestations, two of eight (25%) patients with placenta previa, and none of the 66 grandmultiparous women had transfusions. These data suggest that autologous blood donation may not be beneficial or cost effective when the low frequency of blood transfusions in this high-risk obstetric population and the difficulty in accurately predicting those likely to require transfusions are considered. © 1990.