全前置胎盤妊婦に施行した自己血輸血の1例

抄録

We report autologous blood donation for a pregnant woman with total placenta previa. A 32 -year-old primipara female underwent elective cesarean section due to total placenta previa. From 3 weeks prior to the planned date of cesarean section, 300ml of blood was collected every week and a total of 900ml of blood was stored. During drawing blood, the patient was placed under observation of the fetal heart rate, uteroplacental Doppler waveform patterns and uterine contractions. No uterine contractions, abnormal patterns of fetal heart rate and Doppler waveform were seen. Finally the decrease in hemoglobin of the patient was 0.3g/dl. Under monitoring of kinetics of the iron metabolism, the patient was placed on a supplementation of elemental iron suitably in hospital. While intraoperative blood transfusion was not required, the patient became anemic and complained of malaise 3days after the operation. Then the patient received transfusion of a total of 300ml of the autologous blood. After the transfusion, the general condition of the patient was improved. We advocate that autologous blood donation in obstetrics is safe and advantageous for a part of pregnant woman with high risk for obstetrical hemorrhage. [Adv Obstet Gynecol 47 (3); 365-372, 1995 (H7.5)]