Study On The Clinical Effect Of Preoperative Autologous Blood Donation In The Third Trimester

Objective:To explore the effect of preoperative autologous blood donation in the third trimester on maternal and infant,and to observe the condition of re-transfusion after delivery,so as to provide reference for the more safe and effective implementation of PABD in clinic.Methods:Clinical data of 127 parturient women who underwent PABD in our hospital from May 2015 to March 2020 were collected.The t test was used to compare the changes of red blood cell(RBC),hemoglobin(HGB),RBC deposited(Hct)and platelet(Plt)before and after blood collection,and to observe the fluctuation of peripheral oxygen saturation,blood pressure,pulse,respiration and other vital signs during blood collection?During blood collection,whether the pregnant woman has serious adverse reactions of vagal reflex(such as palpitations,shortness of breath,weakness,dizziness and syncope).Continuous electronic fetal heart monitoring was conducted to observe the changes of fetal heart rate,and statistical analysis was conducted on the condition of autologous blood re-transfusion and maternal and neonatal outcomes.Results:1.There are 93 cases of pregnant women who had prestored blood once,the mean values of RBC,HGB,Hct and Plt decreased before had prestored blood,with statistically significant difference(P < 0.05)and the mean HGB after prestored blood was113.06g/L.There are 31 cases of pregnant women who had prestored blood twice,the mean values of RBC,HGB,Hct and Plt decreased before had prestored blood,with statistically significant difference(P<0.05)and the mean HGB after prestored blood was110.39g/L.There are 3 cases of pregnant women who had prestored blood three times,the mean values of RBC,HGB and Hct after the third prestored blood were lower than those before the first prestored blood,while the mean values of Plt were higher.RBC and HGB showed statistically significant difference(P < 0.05),while Hct and Plt showed no statistically significant difference(P > 0.05)and the mean HGB after prestored blood was 107.33g/L.2.During the course of PABD,127 pregnant women with peripheral oxygen saturation,blood pressure,pulse,respiration and other general vital signs were stable,and there were no adverse reactions of severe vagal reflex(palpitation,shortness of breath,dizziness and syncope).Fetal motion and continuous electronic fetal heart monitoring were not significantly abnormal.3.Among the 127 cases of parturient women undergoing PABD,one case received hysterectomy due to the central placenta previa with the pernicious placenta previa and the placenta percreta.The rest of parturient women and neonates had a good prognosis.The Apgar score of 127 neonates at 5 minutes was 10.00 ±0.00 points and the birth weight was 3174.80±452.59 g.4.The total rate of autologous blood re-transfusion was 65.03%,and that of perinatal high-risk bleeding group was 85.05%.Conclusion:1.Under strict management,PABD is a safe and effective blood transfusion method in the third trimester.2.PABD has certain advantages in reducing the risk of allogeneic blood transfusion,relieving blood source tension,solving emergency blood transfusion after delivery and promoting postpartum recovery.3.At present,PABD still has some limitations,so it is still necessary to improve the PABD implementation plan to prevent anemia after blood collection,establish an accurate prediction system for postpartum hemorrhage,select the best time for blood collection,improve the extraction and preservation of blood components,and not only meet the needs of blood transfusion,but also reduce the waste of blood resources.