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

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.