[Avoidance of homologous blood transfusions in gynecology and obstetrics]

Public concern about the safety of transfusion was aroused by the discovery that the acquired immuno deficiency syndrome (AIDS) can be transmitted by blood transfusion. Patients who require transfusion are now apprehensive to the point of seeking alternatives or even refusing to receive blood. "Autologous transfusion" of the patients own blood can completely eliminate the risk of disease of transmission. Autologous transfusion can be accomplished in different ways: through intraoperative salvage and retransfusion of the patient's blood during surgery, and through donation by the patient of the required amount of blood before surgery. Intraoperative salvage is, to some degree at least, an alternative to transfusion of homologous blood for many surgical patients. Predepositing of blood is an alternative for patients whose elective surgery is scheduled far enough in advance (about 3 weeks) to permit deposit of the required amount of blood. Greater use of predonation would reduce the risk of hepatitis and other transfusion-associated illnesses. It should be noted that any transfusion in obstetrics and gynecology - autologous or homologous - may need a severe indication.