Managing Complications in Pregnancy and Childbirth: - IAWG

C-24 Clinical use of blood, blood products and replacement fluids• Unnecessary transfusion can:- expose the woman to unnecessary risks;- cause a shortage of blood products for women in real need.Blood is an expensive, scarce resource.RISKS OF TRANSFUSIONBefore prescribing blood or blood products for a woman, it is essentialto consider the risks of transfusing against the risks of not transfusing.WHOLE BLOOD OR RED CELL TRANSFUSION• The transfusion of red cell products carries a risk of incompatibletransfusion and serious haemolytic transfusion reactions.• Blood products can transmit infectious agents—including HIV,hepatitis B, hepatitis C, syphilis, malaria and Chagas disease—tothe recipient.• Any blood product can become bacterially contaminated and verydangerous if it is manufactured or stored incorrectly.PLASMA TRANSFUSION• Plasma can transmit most of the infections present in whole blood.• Plasma can also cause transfusion reactions.• There are very few clear indications for plasma transfusion (e.g.coagulopathy) and the risks very often outweigh any possiblebenefit to the woman.BLOOD SAFETY• The risks associated with transfusion can be reduced by:- effective blood donor selection, deferral and exclusion;- screening for transfusion-transmissible infections in the blooddonor population (e.g. HIV/AIDS and hepatitis);- quality assurance programmes;