Neonata l and Obstetric Transfusion

Up to four weeks of birth a newborn is considered a neonate. Most often, these neonates are in need of blood or one of its components. The naturally occurring ABO antibodies are not fully developed in neonates and the presence of Wharton's jelly poses problems in routine grouping and cross matching procedures. Indications and the guidelines for transfusion are different in cases of neonates. Extra precautions are recommended. The proper choice of component is of utmost importance. Hemolytic Disease of Newborn (HDN) is a frequently encountered disorder, occasionally requiring exchange transfusion. The indications, procedure and the complications of Exchange Transfusion have to be understood properly by the pediatricians before employing the procedure, especially in low birth weight babies. The transfusion in obstetric cases and in post partum hemorrhage (PPH) too requires guidelines, which have to be followed. Most of the deaths in obstetrics take place due to PPH which is preventable if the obstetricians take precautions and start the transfusion timely. Beside PPH, perioperative hemorrhage is often an indication for transfusion. All pregnant women must be monitored regularly for iron deficiency anaemia , hemoglobinopathies and alloantibodies during their antenatal period. Neonates quite often require blood transfusion and their requirements are different and unique. A normal neonate has approximately 85 ml/kg of blood volume. Frequent blood collection for laboratory investigations leads to iatrogenic blood loss and need for transfusion.