Managing Complications in Pregnancy and Childbirth: - IAWG

C-28 Clinical use of blood, blood products and replacement fluidsPRESCRIBING BLOODPrescribing decisions should be based on national guidelines on theclinical use of blood, taking the woman’s needs into account.• Before prescribing blood or blood products for a woman, keep inmind the following:- expected improvement in the woman’s clinical condition;- methods to minimize blood loss to reduce the woman’s needfor transfusion;- alternative treatments that may be given, including IVreplacement fluids or oxygen, before making the decision totransfuse;- specific clinical or laboratory indications for transfusion;- risks of transmitting HIV, hepatitis, syphilis or other infectiousagents through the blood products that are available;- benefits of transfusion versus risk for the particular woman;- other treatment options if blood is not available in time;- need for a trained person to monitor the woman andimmediately respond if a transfusion reaction occurs.• Finally, if in doubt, ask yourself the following question:- If this blood was for myself or my child, would I accept thetransfusion in these circumstances?MONITORING THE TRANSFUSED WOMANFor each unit of blood transfused, monitor the woman at the followingstages:• before starting the transfusion;• at the onset of the transfusion;• 15 minutes after starting the transfusion;• at least every hour during the transfusion;• at 4 hour intervals after completing the transfusion.