Autologous Blood Transfusion for Ectopic Pregnancy: A Simple Solution to a Complex Problem

Abstract

Background: Ruptured ectopic pregnancy can cause life threatening hemorrhagic shock in females. Allogenic blood transfusion is limited in resource-constrained settings but autologous blood is readily available. This study reports a case series of autologous blood transfusions performed between September and November 2004 in an emergency hospital run by Doctors Without Borders in Monrovia, Liberia in West Africa during a period of civil war in the country. Methods: Out of a total 180 major surgery performed during that time, 16 were for ectopic pregnancy. After relevant history and examination, four quadrant aspiration of abdomen with 10 ml syringe was performed in suspected cases of ectopic pregnancy. Resistance free aspiration of blood in the syringe was taken as positive for intra-peritoneal hemorrhage and received immediate surgery. Blood was collected from the patient’s abdominal cavity with a bowl, filtered through 9 layers of gauze, packed into ACD bottles and transfused intra-operatively. Results: A minimum of 700 and maximum 2250 ml of blood was thus transfused. All patients survived the surgery with no operative or transfusion related complications and were discharged home within a few days. Conclusion: Autologous blood transfusion is a safe, simple and economic alternative to allogenic blood transfusion for surgeries, like ectopic pregnancy, in resource limited setting.