Blood transfusion in contemporary obstetric practice

Article Abstract:

A blood transfusion may be required by the mother during or after the birth of a baby. Transfusion of donated blood continues to carry health risks, despite the availability of techniques to match blood types and test for contamination with infectious agents, such as the viruses that cause AIDS and hepatitis. The risks of transfusion include that other infectious organisms can be transmitted, minor blood factor incompatibilities can develop, and white blood cell reactions can occur. Some studies have shown that pregnant women can donate two or more units of their own blood in advance, in case a transfusion is needed. Information regarding use of blood transfusions was collected from the medical records of 30,621 deliveries. Increased transfusion rates were seen in women who had previously had an abortion, and pregnancies complicated by: bleeding; increased or decreased amount of amniotic fluid; cesarean delivery; multiple fetuses; and abnormal placement of the placenta. Women receiving labor-augmenting drugs were 2.3 times more likely to require blood transfusion. Of the 795 patients (2.6 percent of subjects) requiring blood transfusion, 84 patients (11 percent) received one unit of blood, 486 patients (61 percent) received two units, and only 28 patients (4 percent) received more than eight units; this last group constituted only 0.09 percent of the entire subject group. There has been a trend toward the less frequent use of blood transfusions over the past 10 years. Since most of the women who had transfusions did not require more than three units of blood, it is suggested that women who are likely to need a transfusion may want to pre-donate three units of their own blood before delivery. This could easily be accomplished over a three-to-four-week period by most pregnant women. Pregnant patients at high risk for excessive bleeding at delivery should be informed of this option by their physicians well in advance of their due date. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Management, Practice, Pregnant women, Uterine bleeding, Uterine hemorrhage, Obstetrics, Blood transfusion, Autologous, Autologous blood transfusion

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Retrospective study of fetal effects of prolonged labor before cesarean delivery

Article Abstract:

Complications during childbirth have been associated with impairment of child development. Among 352 cesarean sections performed between 1952 and 1954 at one hospital, 97 cases involved infants delivered after prolonged labor, and 54 infants were delivered without complications. The relation between intelligence quotient (IQ) and prolonged labor followed by cesarean section was assessed in 122 children. The IQ values of children delivered by cesarean section after a prolonged labor were compared to those of their siblings delivered by planned cesarean section without labor. Analysis of results revealed that increasing duration of labor before cesarean section was associated with adverse effects on IQ. In 30 families, the children who were delivered after more than 12 hours of labor had lower IQs than their siblings. In addition, children who were delivered after prolonged labor tended to have the lowest IQs in their families. However, all children within a single family had similar patterns of success in school. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Evaluation, Physiological aspects, Children, Childbirth, Delivery (Childbirth), Cesarean section, Intelligence (Psychology), Intelligence tests, Intelligence levels

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