Every day, about 800 women die from

pregnancy or childbirth-related complications.

Severe bleeding during delivery and after
childbirth is a major cause of mortality,
morbidity and long-term disability. The goal of
the campaign is to increase awareness about
why timely access to safe blood and blood
products is essential for all countries as part of
a comprehensive approach to prevent
maternal deaths.
Severe bleeding during delivery or after childbirth is the commonest
cause of maternal mortality and contributes to around
- 34% of maternal deaths in Africa,
- 31% in Asia and
- 21% in Latin America and the Caribbean.
Severe bleeding during delivery and after childbirth is a major cause
of mortality, morbidity and long-term disability.
Blood transfusion has been identified as one of the nine key life-
saving interventions for the management of pregnancy-related
complications as part of a comprehensive approach to maternal and
newborn care that should be available in all facilities providing
comprehensive emergency obstetric care.
Blood transfusion history dates back about 200
years and is relatively recent considering the
history of mankind. The credit of first successful
human to human blood transfusion goes to Dr
James Blundell, an obstetrician, who
successfully transfused 8 oz (227ml) of blood to
a patient of postpartum haemorrhage in 1818.
In 2014, more than 40 years after the first World Health Assembly
resolution (WHA28.72) addressed the issue of blood safety,
equitable access to safe blood and blood products and the rational
and safe use of blood transfusion still remain major challenges
throughout the world; and many patients requiring transfusion,
particularly mothers and children in developing countries, do not
have timely access to safe blood.
WHO has been providing support for strengthening service delivery
and safety for obstetric care including improving access to safe blood
and blood products for women and children and improve
collaboration with maternal and child health, HIV/AIDS and malaria
programmes.
According to the World Health Organization (WHO), the four
cornerstones of a safe and effective blood donor service are a
national system, volunteer donations, blood testing, and avoidance of
unnecessary transfusions.
Blood transfusion should be discussed with pregnant women as early
as possible so that misconceptions can be addressed or alternate
treatment options considered should the need for blood arise.
Alternatives to allogenic blood transfusion proposed to circumvent
the difficult issues of donation, testing, safety, storage, and cost
include preoperative autologous blood donation, perioperative
hemodilution, and intraoperative autologous transfusion.
Each of these cornerstones poses challenges in developing countries,
where infrastructure may be limited; the cost of blood procurement,
screening, and storage is high; and blood donation is rare.
Fear and ignorance related to blood donation are the main
impediments that keep people from engaging in this life saving task.
Anybody who is not suffering from any chronic disease, weighing
more then 47 kg, fit and aged between 18 to 64 years should be able
to give blood every 4 months. Plasma donation is possible every 2
weeks provided the red cells are returned to the body. Unfortunately
such technology is only available in Central Military Hospital and yet
to be available for the masses.
look for donors among friends and family
It is really difficult to find donors at times of emergency, when the
patients blood type is rare. People often seek help from blood
donation agencies because they cant find relatives or friends to
match the patients group. This is understandable if the blood type is
uncommon (especially negative blood types) but the more common
blood types can easily be found among members of the same family.
To further emphasize the need to protect our family members from adverse effects of blood transfusion, a
list of the side effects attributable to transfusion will be summarized shortly. The serious infections which
may spread, if blood is taken from any of the wide number of unscrupulous agencies which have cropped up
around the country are given below:
- HIV/AIDS Virus (even in countries like Canada where they use state-of-the-art technology to detect
infection, the odds of transfusion dependent HIV is < 1 in 7000,000. No data is available in Bangladesh )
- Hepatitis B and C Infection. Transfusion related Hepatitis was first reported during the Second World War.
- Epstein Barr Virus and Cytomegalovirus are other blood borne viral infections.
- Bacterial infections include: S. aureus, S. epidermidis, Bacillus cereus, Treponema pallidum ( responsible for
Syphilis), Klebsiella, Serratia, Pseudomonas, Yersinia. Each organism having its own spectrum of virulence.
But all transfusion related illnesses are not harmful on the long run and may be abated by simple measures
during hospital stay.
- Febrile Non-Hemolytic Transfusion Reactions (FNHTR)
This occurs due to immunological reactions between antibodies and antigens present in
donors plasma or White Blood Cells. The patient will suffer fever, rigors, facial flushing,
hypotension etc.
If fever is more then 100.40F transfusion is stopped and treatment is given with antipyretics
and anti histamines.
- Acute Hemolytic Transfusion Reaction (AHTR)
This reaction is life threatening and often results due to mismatched blood transfusions
attributable to clerical errors/ faulty technique/ lack of proper reagents and equipment.
Patient presents with fever, chills, hypotension, back or flank pain, breathlessness, etc.
This emergency condition requires maintenance of Blood Pressure with saline, dopamine
and other life saving maneuvers.
look for donors among friends and family
Blood can save life. It should be our solemn pledge to our family,
friends and society to help them with safe blood at times of
emergency. Even at crucial periods one must always look for donors
within the family before seeking help from donor agencies simply
because an infected blood bag could lead to further morbidity. It
could also strengthen family ties which are so close to being severed
or even bring a feeling of satisfaction in the heart of the donor for he
helped his brother in distress.