©Pregnancy bliss 2008
If blood transfusion is that beneficial, why is it not given as a matter of course to every pregnant SCD sufferer?
One wishes solutions were that simple and straightforward!
Even though modem blood transfusion is extremely safe, problems remain. The potential for these problems increases the bigger the number of transfusions.
The transmission of viral infections via blood transfusion has been virtually eliminated, but there is always a risk, however tiny this might be. That is why the universal wisdom of not to transfuse unless necessary still holds true.
There is also the virtually unpreventable risk of developing what are known as atypical antibodies as a result of repeated transfusions. These antibodies could affect the fetus to the extent of triggering preterm delivery and exchange transfusions at birth.
All these mean that transfusions should be offered and given only when a meticulous assessment shows that it is necessary.
Situations where blood transfusion is considered necessary for a pregnant SCD sufferer
If a general anesthetic is required, let's say for a cesarean section, then blood transfusion will be given, usually beforehand unless the urgency for the operation means this is impractical. In such a case, alternative forms of anesthesia (such as a spinal) may be considered and adopted.
Preparations for labor and delivery in SCD
For SCD sufferers, it is imperative that any conditions which could precipitate a crisis are avoided. if the person falls ill, dehydration can be prevented by ensuring adequate fluid intake, usually by the intravenous route.
Screening for possible urinary tract infection is normally done regularly, especially towards the end of pregnancy. It will need to be done routinely at the onset of labor as well.
Labor itself will be managed actively to ensure that there is no maternal distress or exhaustion and that it is not prolonged.
Blood will always be available, in case transfusion becomes necessary.