ALL patients should have a group and screen submitted to blood bank at some point in their pregnancy
MOST patients DO NOT need a second in-date group and screen. MSBOS data show the transfusion rate for “routine” C-section to be 1.7%; vaginal delivery is 0.3%.
If you think your case is high risk enough that likelihood for blood transfusion is >10%, you will STILL require a SECOND in-date G+S (ie., G+S within 72 hours).
Placenta previa MSBOS transfusion rate is 19% (support in-date G+S for this)
All placenta accreta cases should also have in-date G+S
Although this is a somewhat moot point given lack of access to OR blood fridge on M5, it is important to point out that RBCs will always be issued directly from blood bank due to need for Kell-negative blood.
Regarding CBCs:
Current policy is for CBC within 30 days of the booked C-section
Given that a proportion of booked C-sections may be medically indicated and booked slightly pre-term (eg. 36 weeks GA), setting a gestational age cutoff for CBC is likely not practical
If you believe you will require an updated CBC and G+S on the day of surgery, it remains the our responsibility to order these ahead of time to ensure cases to not get delayed. It is probably most efficient to call the nursing station (x6995) the day before to add an order for bloodwork to be drawn on the patient’s arrival to triage.
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