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 - voluntary 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.
Criteria of voluntary blood donation 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. Look for donors among friends and 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.
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.