Rh（D）抗原陰性の腹腔内大量出血に対し回収式自己血輸血を用いて腹腔鏡下手術を行った卵巣出血の一例

抄録

Introduction: Blood transfusion may be required due to massive bleeding in patients with ectopic pregnancy, though allogeneic blood transfusion can be complicated by infection. Furthermore, Rh(D) antigen-negative blood is not always available. This report presents a patient who was Rh(D) antigen-negative with suspected ectopic pregnancy who underwent laparoscopic surgery with autologous blood transfusion. She was ultimately diagnosed with ovarian hemorrhage.

Case: A 29-year-old gravida 1 para 0 woman presented six weeks and zero days after her last menstrual period with lower abdominal pain. She was transferred to our hospital with suspected ectopic pregnancy and received four units of Rh(D) antigen-negative red blood cells. No additional allogeneic blood was available for transfusion; therefore collected autologous blood was used for intra-operative transfusion during an exploratory laparoscopic surgery. Surgery revealed bleeding from the right ovary. A right partial oophorectomy was performed, though no chorion could be confirmed. The operation lasted two hours and nine minutes. The estimated blood loss was 2,531 mL. The postoperative hemoglobin was 7.2 g/dL, and 1,100 ml of collected autologous blood was transfused. The final diagnosis was right ovarian hemorrhage.

Discussion: Autologous blood transfusion can be conducted when allogeneic blood is difficult to secure.