Transfusion Management of the Obstetrical Patient

235 Pages·2018·2.822 MB·English

by  Theresa Nester

Theresa Nester
Editor
Transfusion
Management of the
Obstetrical Patient
A Clinical Casebook
123
Transfusion Management
of the Obstetrical Patient
Theresa Nester
Editor
Transfusion
Management of the
Obstetrical Patient
A Clinical Casebook
Editor
Theresa Nester
University of Washington Medical Center
Bloodworks Northwest
Seattle
Washington
USA
ISBN 978-3-319-77139-7 ISBN 978-3-319-77140-3 (eBook)
https://doi.org/10.1007/978-3-319-77140-3
Library of Congress Control Number: 2018942631
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To the families who have
lost a mother, wife, daughter,
or sister to postpartum
hemorrhage or other
complications of pregnancy.
We hope that our energy
directed toward making this
a “never” event reaches you
and helps you to heal.
Preface
This series of case sections has been assembled to help
educate clinicians and laboratorians so that they may better
understand transfusion and therapeutic apheresis support of
obstetrical patients. A main focus is on management of a
patient experiencing postpartum hemorrhage, both in terms
of tools available to the obstetrician and the anesthesiologist
and in terms of blood component therapy and laboratory
testing that should be used to monitor such a patient. Several
sections cover basic transfusion medicine theory, so that the
principles of safe transfusion practice are shared. Smaller yet
very important topics include prevention of sensitization to
RhD in an RhD negative woman and the differentiation of
causes for microangiopathic hemolytic anemia in pregnancy.
Case examples of red cell antibodies found on prenatal test-
ing, and subsequent management, are also presented. An
overarching goal is to highlight situations where transfusion
medicine consultation may help contribute to optimal patient
care. The authors have done an excellent job covering the
topics at hand. Yet, it is an incomplete work, in that large
numbers of prospective, randomized clinical trials are often
not available to help guide the management of these patients.
Where evidence is available, it is cited. Beyond that is the
compilation of knowledge gained by in-depth experience.
vii
viii Preface
We hope that the information presented helps to reduce the
morbidity and mortality that can result from complications
associated with pregnancy.
Seattle, WA Theresa Nester
Contents
1 O bstetrical Management of Postpartum
Hemorrhage .................................. 1
Michael Dombrowski and Michael Paidas
2 L aboratory Testing and Predictors of Severe
Postpartum Hemorrhage ....................... 15
Evelyn Lockhart
3 C omponent Therapy in Obstetric Hemorrhage..... 23
Joseph Griggs
4 E vidence for 1:1:1 Transfusion Support and Importance
of a Hemorrhage Protocol ...................... 39
Mark Fung and Sarah Harm
5 Evidence for/Against Administration
of Antifibrinolytic Agents During an Obstetrical
Hemorrhage .................................. 47
Kerry L. O’Brien
6 E vidence for/Against Administration of Fibrinogen
Concentrate and Coagulation Factor Concentrate
During an Obstetrical Hemorrhage .............. 55
Michael Dombrowski and Michael Paidas
7 R ecommendations on Blood Recovery
in Obstetrics .................................. 67
Gerhardt Konig
ix
x Contents
8 Thrombocytopenia in Pregnancy................. 73
Thomas G. DeLoughery
9 V on Willebrand Disease in Pregnancy ............ 81
Thomas G. DeLoughery
10 P latelet Count and Neuraxial Anesthesia ......... 91
Cathleen Peterson-Layne and Beth R. Burton
11 ABO Compatibility............................ 97
Theresa Nester
12 RhD Compatibility ............................ 103
Jessica Poisson
13 O ther Rh Antibodies That Can
Impact Transfusion ............................ 107
Jessica Poisson
14 I mportance of Getting a  Sample for ABO
Type Early in a Resuscitation.................... 113
Ashok Nambiar
15 R isks of Giving Uncrossmatched Red Cells........ 121
Ashok Nambiar
16 M anagement of Thrombotic Microangiopathies
in Pregnancy.................................. 131
Jeffrey L. Winters, Vesna D. Garovic,
Layana Alrahmani, and Kristina A. Davis
17 H yperhemolysis Syndrome in a Pregnant Woman
with Sickle Cell Anemia ........................ 155
Henry Hilt and Oyebimpe Adesina
18 Fetal and Neonatal Alloimmune
Thrombocytopenia............................. 163
Justin Juskewitch and Jeffrey L. Winters
Contents xi
19 W eak D in Pregnancy .......................... 179
Meghan Delaney
20 T esting Algorithm for Rh Immune
Globulin Dosing in the Post-natal RhD-N egative
Mother....................................... 187
Theresa Nester
21 P re-transfusion Testing in Women with High Bleeding
Risk Requiring Prolonged Hospitalization ........ 193
Theresa Nester and Katherine L. Eastwood
22 W arm Autoantibodies During Pregnancy ......... 201
Chakri Gavva
23 H emolytic Disease of the Fetus
and Newborn/Selection of Red Cells
for Intrauterine Transfusion..................... 207
Brian Gorospe and Nabiha Huq Saifee
24 M aternal Red Cell Alloantibody Directed Against
a High Incidence Antigen....................... 217
Theresa Nester
Index ........................................... 223