Mothers and their babies depend on the generosity of blood donors to ensure that they return to good health following labor and delivery.
“As a Maternal-Fetal Medicine specialist, I have at least two patients at a time — mom and baby — and both need ample blood to stay well,” said Lisa Zuckerwise, MD, FACOG, assistant professor, Division of Maternal-Fetal Medicine and associate program director, Maternal-Fetal Medicine fellowship.
By term, a pregnant patient has, on average, over a half liter of blood flowing to the uterus per minute. At birth, hemorrhage can be swift and unrelenting, and transfusion volume needs may be massive. This is especially true for patients with complications of placentation, such as placenta previa (low implantation of the placenta) and placenta accreta spectrum (attachment of the placenta into the uterine wall), where massive hemorrhage and need for large volume transfusion is truly the difference between maternal survival and loss of a mom before she even meets her baby.
During delivery of patients with placenta accreta spectrum, over 50% of patients will receive more than four units of red blood cells, and transfusions of over 10 units of blood products are not uncommon, Zuckerwise said.
VUMC is experiencing severe shortages of O positive and O negative red blood cell units, which are expected to continue. To address this, the VUMC Blood Bank is auditing every order of O positive and O negative red blood cells for appropriateness and canceling or limiting orders that don’t meet VUMC guidelines, among other measures.
The American Red Cross holds frequent blood drives on VUMC’s 21st Avenue and One Hundred Oaks campuses. Employees and members of the public are encouraged to donate. You can sign up for an upcoming Red Cross blood drive and donate at a time convenient with your schedule at https://news.vumc.org/2021/11/10/vumc-continues-to-see-critical-blood-shortages/
“Our fetal patients comprise another population that relies on an adequate supply of blood on hand. While they are small and not in need of large volume transfusion, they, too, can experience life-threatening anemia and transfusion need,” Zuckerwise said. “At Vanderbilt, we are a referral center for the most complex fetal patients, and we have been in a situation where there were only two units of safe blood in the entire United States for a specific mom-baby pair. This truly highlights the importance of regular donation by all able-bodied adults, so that we never face the situation of a baby in need without the necessary blood supply.”
