As every year, June 14 is World Blood Donor Day, a date chosen by the World Health Organization to raise awareness among the population that lives can be saved with a simple gesture. Most people can do it if they are in good health and meet a series of conditions (weight, age, physical conditions ...), but there are also cases in which you have to be more cautious, for example, Can you donate blood during pregnancy?
Donating blood is a necessity and in part and in my opinion an obligation. Medically it is a basic element for our health and, according to data provided by the National Health System, 4 donations are needed per year for every 100 inhabitants. ANDn Spain, we are on our way to 50 million inhabitants, so they need 2 million donations a year to guarantee a system that can help us all.
There are many cases in which blood donation is not recommended, without going into detail, cardiovascular diseases, hemorrhagic diseases, diabetes, hypertension, sexually transmitted diseases, cancer or drug use, among others, are exclusion criteria. Likewise, a temporary exclusion criterion is the realization of a tattoo, drug treatment, recent interventions or oral treatment.
Today I want to focus, as a gynecologist, on the situation of pregnancy or lactation and the viability of donating blood or not with a fetus inside us or a baby in our chest.
After a blood donation, our body loses components that circulate through our bloodstream. Approximately 24 hours after extraction, our body has usually recovered all the volume of lost fluid, returning to its normal level. Therefore, it is advisable not to perform physical or dangerous activities that require extra effort.
However, despite only being 24 hours for the recovery of the entire amount of blood, the platelet level does not return to its initial state until three days after the blood loss. Therefore, the inherent risk of a low platelet level must be preserved during that time. But the thing is not there, another component of our body, which serves to transport oxygen, such as red blood cells can take around 60 days to return to their initial level. There are many more components that are lost with the extraction, I show you their relationship with the pregnancy situation.
It is clear that pregnancy is not a situation, much less one of illness or disability, but it is a stage in the life of women in which the risks that may exist in our environment must be minimized and where our requirements are special.
There are several specific risks and circumstances that do not make donation recommended during this stage, such as:
During pregnancy, a greater amount of iron is required for the correct development of the fetus, childbirth usually entails a significant loss of iron levels in the mother (which entails a recovery time). Iron is intimately bound to the bloodstream.
With the possible extraction of blood at this stage, iron levels clearly decrease, and it can cause anemia, which has been frequent. Both a maternal anemia, which leads to poor physical conditions in the mother (malaise, dizziness, loss of strength, etc.), and even more serious, fetal anemia, which in extreme cases can trigger fetal death.
A severe blood deficit can lead to maternal hypoxia (lack of oxygen), which translates into more serious cases in lack of irrigation of certain maternal organs, including, at that stage, the placenta and pregnancy, which demands a large amount of blood supply and oxygen, among other components. With the consequences that can be imagined for the proper development of the fetus.
The function of platelets is healing, a deficit of these in childbirth, cesarean section, curettage or abortion can cause serious consequences of bleeding.
The reasons for non-donation are not simply for possible risk of the mother or baby, but for third parties. After pregnancy, some women have antibodies that can bring complications to patients who receive it during a transfusion.
It is not recommended that possible donation after pregnancy not be made until 6 months after birth (or abortion if any) or completion of breastfeeding. In the latter case of breastfeeding, it is recommended, if it is decided to donate, an analysis of these antibodies to know their viability in the employability of this blood to possible patients.
However, donating during breastfeeding still has benefactors and detractors, each organization in charge of the extraction usually has its own policy
The Spanish legal system answers the question we are asking ourselves, 'Can a pregnant woman donate blood?', and it is specifically Royal Decree 1088/2005, of September 16, which repeals the previous one, which establishes the technical requirements and minimum conditions for hemodonation to transfusion centers and services.
This decree indicates that in the case of being pregnant there is 'exclusion of six months after delivery or interruption of pregnancy, except in exceptional circumstances and at the discretion of the doctor' and does not expressly indicate the period of breastfeeding.
During the search for pregnancy, there is no incidence whatsoever, so blood can be donated without incidence. In cases where blood is donated without knowing a possible recent pregnancy, it should not cause a higher incidence, since the needs during the first trimester of pregnancy are lower than in the following stages. Finally, in women with menstruation donation is totally feasible.
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