Primum, non nocere: Whole blood, prehospital transfusion and anti‐D hemolytic disease of the fetus and newborn.

However, it appears, when reviewing the available evidence and weighing risks and benefits, patients of childbearing potential who are DNEG or when the RhD type is unknown should not routinely be exposed to DPOS red cells for the purpose of receiving a pre-hospital or WB transfusion. Keywords: transfusion complications- non infectious; transfusion practices (adult); transfusion practices (OB GYN) EN transfusion complications- non infectious transfusion practices (adult) transfusion practices (OB GYN) 249 256 8 01/17/23 20230101 NES 230101 Abbreviations RBC red blood cells DNEG RhD negative HDFN hemolytic disease of the fetus and newborn ONEG group O, RhD negative OPOS group O, RhD positive WB whole blood MFM maternal-fetal-medicine Blood banking practice has endeavored to ensure patients of childbearing potential in urgent need of a red blood cell (RBC) transfusion receive RhD negative (DNEG) RBCs if they are DNEG or when an Rh type is unknown.[[1], [3]] The rationale is to prevent DNEG patients from forming anti-D alloantibodies and having a future pregnancy at risk of anti-D hemolytic disease of the fetus and newborn (HDFN).[5] There have been several recent articles presenting the case that this practice should be reconsidered to ensure optimal trauma care as, due to supply issues, it is difficult to provide group O RhD-negative (ONEG) RBCs in the pre-hospital setting or when using whole blood (WB).[[6], [8], [10], [12]] The recommendation is that group O RhD-positive (OPOS) RBCs or WB be used in these circumstances since the benefit of transfusion outweighs the harm to a patient of childbearing potential developing anti-D and having a pregnancy affected by HDFN. [Extracted from the article]