Feasibility of autologous blood donation in patients with placenta previa

Debate continues as to whether autologous blood donation is feasible in patients with placenta previa. A recent study in a university setting concluded that routine autologous donation in patients with placenta previa is not indicated. In our study we assessed the feasibility of autologous blood donation for patients with placenta previa in a community-hospital setting.

We performed a chart review over a 5-year period of all patients admitted with placenta previa. A theoretical model was then applied to this data. To be eligible for autologous donation, the patient would need to be asymptomatic and have a hemoglobin level of 11 gm/dL or higher at 32 weeks' gestation.

Fifty-nine patients were admitted with uncomplicated placenta previa, 34% (20) of whom were eligible for autologous donation. We found that 20% (4) of patients who met eligibility criteria for autologous blood donation would have benefitted from predonation, and 10% (2) of patients meeting eligibility criteria might have become anemic at delivery because of the donation.

Autologous donation is not feasible in most patients with placenta previa. However, the proportion of patients eligible for autologous blood donation in a community-hospital setting is 2.5 times the proportion of eligible donors in a university hospital setting (P = .003). Asymptomatic patients with placenta previa diagnosed by 32 weeks, who have a hemoglobin level of 11 gm/dL or above, may be safely offered this option.