New campaign says give blood for Mother’s Day

Feb 25 2008 by Madeleine Brindley, Western Mail

Every year pregnant women and babies require blood transfusions. As the Welsh Blood Service launches a major donor recruitment campaign for Mother’s Day, health editor Madeleine Brindley explains why

THE latest series of television adverts urging us to donate blood tells us we need to give to help those who become injured in some kind of accident, or undergo complications during surgery.

But these adverts don’t mention the youngest – and most vulnerable – people in society, who rely on life-saving blood transfusions.

Thousands of babies are born safely every year in Wales, but there are a significant number of births where things go wrong – mum-of-three Lesley Hooper needed 120 units when she started bleeding heavily while in labour.

Every year neonatal babies rely on blood transfusions to help their tiny bodies fight for life.

And every year up to 30 pregnant women will receive a blood transfusion at the University Hospital of Wales in Cardiff – not for themselves, but for their unborn child.

It is a tricky and potentially risky procedure – there is a 2% risk of miscarriage – giving a baby in the womb a blood transfusion (the process is known as intrauterine transfusion), but also a potentially life-saving one.

Dr Bryan Beatty, a consultant in fetal medicine, is one of only a small number of people in the UK with the necessary expertise to transfuse donated blood into an unborn child’s umbilical cord or their liver, while they are still in their mother’s womb.

There are two main groups of babies who become anaemic during pregnancy – those with a mismatch of blood groups between the mother and baby and those who have a parvovirus infection.

Dr Beatty said, “In about 15% of all pregnancies there is a risk of mismatch because the mums are Rhesus negative, but not all of them produce antibodies, and the placenta acts as a barrier in most.

“But in some, somehow the baby’s cells leak across to the mum’s side of the circulation and the immune system reacts to these foreign bodies by producing antibodies to destroy the cells.

“The problem is these antibodies are very good at crossing the placenta and they will go to work on the baby’s cells, destroying their red blood cells, making them anaemic.

“If it’s severe, the babies can develop heart failure and die.”

The second group of pregnant women who need an intrauterine transfusion are those with parvovirus – also known as slapped cheek – a viral infection which can be caught from dogs and lives in red blood cells.

Although rare – Cardiff, which treats women from across South, Mid and West Wales, will see two cases a year – it can lead to heart failure.

But a single blood transfusion can cure the unborn baby and many mothers go on to deliver their baby normally in a midwife-led unit.

But these intrauterine transfusions are not without risk. Dr Beatty said, “With transfusions under 26 weeks, there is a 2% chance of losing the baby, but after that we ask the mums to fast before a transfusion so if we do run into difficulties we can do an emergency Caesarean section – to get the baby out in 10 minutes – although this is rare.

“About 90% of babies who need transfusions will survive pregnancy and we usually deliver them at 34 weeks – six weeks early – by Caesarean section and the babies go to special care.

“The main problem we have from that is breathing difficulties, so we also give the mums a couple of injections of steroids to help the babies’ lungs mature,” he added.

Some mothers-to-be and their unborn children may need as many as six or seven transfusions during their pregnancy.

Anywhere between 20ml and 120ml of blood is given during each transfusion, but because units of blood cannot be split between patients, each transfusion requires one unit.

The blood must come from donors who have not had the CMV virus, which causes a mild flu-like illness in adults, and the blood must be irradiated, giving it a very short shelf-life. Dr Beatty said, “We had a couple, who were coming from Haverfordwest for an intrauterine transfusion, but they broke down at one of the services between Swansea and here,” he said.

“Their mobile phone message was pretty garbled and they didn’t know which services they were at.

“The blood only lasts a few hours after it has been irradiated – their baby was very anaemic and we knew that because it was a Friday, we wouldn’t be able to get any more blood until Monday.

“We called the local police and they sent a car out to call at every services between Swansea and Cardiff until they found the couple and they brought the mother here, by police car, to have the transfusion.”

Dr Beatty, who cannot give blood himself after suffering from malaria as a child, added, “I feel humbled by the fact people give up their time, often in the middle of their jobs, to give blood. It is very humbling.”

Trudi Evans, recruitment manager at the Welsh Blood Service, said, “We are calling upon the people of Wales who are able to donate blood to step forward, roll up their sleeves and become official life-savers.

“A regular blood donor can feel proud in the knowledge that because of them, someone’s life has been saved and their health restored – someone like Lesley Hooper.

“My daughter is a blood donor and I am very proud. What better gift could you give this Mother’s Day? Please help make a difference.”

For more information about giving blood or to find a session visit www.welshblood.org.uk or call 0800 252 266

Mum says give blood after traumatic birth almost cost her life

Lesley Hooper has few memories of the birth of her third child, Shane.

She remembers being in labour and being told that her baby was in distress. She remembers a team of experts saying he needed to be delivered quickly.

But after that there is a blank, filled in only by what her husband Stephen recalls.

Although he is now a teenager and a burgeoning motor-cross rider, the memory of Shane’s birth is still a traumatic one for Lesley.

“I didn’t know that he had been born,” the 47-year-old midwife from Newbridge said. “I was bleeding out very fast – my husband said there was blood everywhere and that the floor of the delivery room was like a swimming pool.”

In all Lesley, who has two other children in their 20s, lost six litres of blood during Shane’s birth. She needed some 120 units of blood to keep her alive.

Her blood loss was so severe that additional units of blood had to be flown into the Royal Gwent Hospital in Newport from Cardiff, because the hospital had exhausted its own supplies.

Shane’s birth was recorded as a “major incident” in the hospital’s records.

“I don’t really know the details about what happened,” she said. “I can’t remember having Shane, I just remember waking up however many days later in intensive care.

“I can’t understand why I’m here – I know that people have died after losing five litres of blood. It’s amazing.”

She added, “I’d occasionally given blood when I was younger, but having gone through something like this makes you realise how important it is for everyone who can to give blood.

“I need to say thank you to everyone for my blood, for the staff at the Royal Gwent and for the blood transfusion service for working so well.

“It’s not harmful, the donation doesn’t last long and you soon recover, but it could be your own mother or child who needs that blood.”

Transfusion in the womb

Q What is an intrauterine transfusion?

A This is a blood transfusion given to a baby before it is born.

Q How do you give a baby blood while it is in the womb?

A A fine needle is passed through the woman’s abdomen and the wall of the uterus and into one of the blood vessels in the baby’s umbilical cord or liver. The whole of the procedure is carried out under scan guidance and takes around half-an-hour.

Q Is it dangerous for the baby?

A There is a one-in-50 risk of triggering a miscarriage or premature labour by carrying out an intrauterine transfusion. There is a very small risk of an infection developing inside the uterus and, very occasionally, the baby may react to the blood transfusion and its heart may slow down. There may also be a need to deliver the baby immediately by an emergency caesarean section.