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Cesarean section: is pretransfusion testing for red cell alloantibodies necessary?
Rune Larsen1, Kjell Titlestad, Søren Thue Lillevang
1Department of Clinical Immunology, Odense University Hospital, DK-5000 Odense C, Denmark.
Acta Obstetricia Et Gynecologica Scandinavica
|April 22, 2005
Summary
Routine pretransfusion testing for red cell alloantibodies (RBCab) in cesarean patients is often unnecessary. This study found a very low incidence of clinically significant RBCab, suggesting testing can be omitted to streamline care.
Area of Science:
- Obstetrics and Gynecology
- Transfusion Medicine
- Immunology
Background:
- Routine pretransfusion testing for red cell alloantibodies (RBCab) is standard in cesarean patients.
- The clinical utility of this practice requires evaluation.
Purpose of the Study:
- To assess the usefulness of routine pretransfusion RBCab testing in cesarean patients.
Main Methods:
- Retrospective analysis of computerized registers.
- Data extraction on blood transfusions and RBCab occurrence in cesarean patients.
Main Results:
- Low incidence (0.23%) of previously undetected clinically significant RBCab found.
- Blood transfusions were needed in 3.3% of cesarean sections.
- Estimated probability of undetected RBCab and transfusion is 1 in 11,050.
Conclusions:
- Routine pretransfusion testing for RBCab in cesarean patients can be omitted.
- Sufficient time often exists for postoperative antibody screening if routine testing is removed.