Comparison of group O Rh(D)- red blood cell use in pregnant women across hospitals of various sizes and obstetric capabilities prior to the introduction of patient blood management guidelines

Jillian A Patterson; Rena Hirani; David O Irving; Michael C Nicholl; Jane B Ford; Obstetric Transfusion Steering Committee

doi:10.1111/ajo.13043

Comparison of group O Rh(D)- red blood cell use in pregnant women across hospitals of various sizes and obstetric capabilities prior to the introduction of patient blood management guidelines

Aust N Z J Obstet Gynaecol. 2020 Aug;60(4):498-503. doi: 10.1111/ajo.13043. Epub 2019 Jul 31.

Authors

Jillian A Patterson^{1

2}, Rena Hirani³, David O Irving^{3

4}, Michael C Nicholl^{5

6

7}, Jane B Ford^{1

2}; Obstetric Transfusion Steering Committee

Affiliations

¹ Clinical and Population Perinatal Health Research, The University of Sydney Northern Clinical School, Sydney, New South Wales, Australia.
² Northern Sydney Local Health District, Kolling Institute, Sydney, New South Wales, Australia.
³ Research and Development, Australian Red Cross Blood Service, Sydney, New South Wales, Australia.
⁴ University of Technology, Sydney, New South Wales, Australia.
⁵ University of Sydney, Sydney, New South Wales, Australia.
⁶ Maternal Neonatal and Women's Health Network, Northern Sydney Local Health District, Sydney, New South Wales, Australia.
⁷ Department of Obstetrics and Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia.

PMID: 31368110
DOI: 10.1111/ajo.13043

Abstract

Background: O Rh(D)- red blood cell (RBC) units can generally be transfused to most patients regardless of their ABO blood type and are frequently used during emergency situations. Detailed usage patterns of O Rh(D)- RBC units in obstetric populations have not been well characterised. With the introduction of patient blood management guidelines, historical usage patterns are important for providing comparative data.

Aims: To determine how the use of O Rh(D)- RBC units in pregnant women differs between hospitals of different sizes and obstetric capabilities prior to patient blood management guidelines.

Methods: Data from 67 New South Wales public hospital blood banks were linked with hospital and perinatal databases to identify RBC transfusions during pregnancy, birth and postnatally between July 2006 and December 2010. RBC transfusions were divided into O Rh(D)- or other blood types. Hospitals were classified according to birth volume, obstetric capability and location, with transfusions classified by timing and diagnosis.

Results: Of the 12 078 RBC units transfused into pregnant women, 1062 (8.8%) were O Rh(D)-. Higher use of O Rh(D)- RBC units was seen in antenatal transfusions, preterm deliveries and in regional or smaller hospitals. There was wide variation in rates of O Rh(D)- RBC transfusion among hospitals.

Conclusions: The rate of O Rh(D)- RBC unit use in obstetrics was lower during the period assessed than the nationally reported usage. It is encouraging that O Rh(D)- RBCs were more commonly used in emergency or specialised situations, or in facilities where holding a large blood inventory is not feasible.

Keywords: blood banks; blood grouping and crossmatching; blood transfusion; obstetrics; pregnancy.

Publication types

Comparative Study
Research Support, Non-U.S. Gov't

MeSH terms

Blood Transfusion
Erythrocytes* / immunology
Female
Hospitals
Humans
Infant, Newborn
New South Wales
Pregnancy
Pregnant Women
Rh-Hr Blood-Group System

Substances

Rh-Hr Blood-Group System