Protocol - Prophylactic Transfusion during Pregnancy

Personnel and Training Required

Personnel should be trained in medical record abstraction.

Equipment Needs

None

Requirements

Requirement Category	Required
Major equipment	No
Specialized training	No
Specialized requirements for biospecimen collection	No
Average time of greater than 15 minutes in an unaffected individual	No

Mode of Administration

Medical record abstraction

Lifestage

Adolescent, Adult

Participants

Pregnant people with sickle cell disease

Selection Rationale

These questions from Malinowski et al. (2015) and Oakley et al. (2020) were selected as the best way to capture the details regarding transfusion during pregnancy and hemoglobin levels.

Language

English

Standards

Standard	Name	ID	Source

Derived Variables

NA

Process and Review

[include]

Protocol Name from Source

Malinowski AK, et al. Prophylactic transfusion for pregnant women with sickle cell disease: a systematic review and meta-analysis. Blood. 2015

Oakley LL, et al. Serial prophylactic exchange blood transfusion in pregnant women with sickle cell disease (TAPS-2): study protocol for a randomised controlled feasibility trial. Trials. 2020

Source

Malinowski, A. K., Shehata, N., D'Souza, R., Kuo, K. H., Ward, R., Shah, P. S., & Murphy, K. (2015). Prophylactic transfusion for pregnant women with sickle cell disease: A systematic review and meta-analysis. Blood, 126(21), 2424-2435. https://doi.org/10.1182/blood-2015-06-649319. Items 1-6, 9-10, and 12

Oakley, L. L., Awogbade, M., Brien, S., Briley, A., Chorozoglou, M., Drasar, E., Johns, J., Rhodes, E., Robinson, V., Seed, P., Sharif, J., Singh, C., Telfer, P., Thompson, H., Watt-Coote, I., Howard, J., & Oteng-Ntim, E. (2020). Serial prophylactic exchange blood transfusion in pregnant women with sickle cell disease (TAPS-2): Study protocol for a randomised controlled feasibility trial. Trials, 21(1), 347. doi:10.1186/s13063-020-4212-8. Items 7-8, 11, and 13

General References

Koshy, M., Burd, L., Wallace, D., Moawad, A., & Baron, J. (1988). Prophylactic red-cell transfusions in pregnant patients with sickle cell disease. A randomized cooperative study. The New England journal of medicine, 319(22), 1447-1452. https://doi.org/10.1056/NEJM198812013192204

Okusanya, B. O., & Oladapo, O. T. (2013). Prophylactic versus selective blood transfusion for sickle cell disease in pregnancy. The Cochrane database of systematic reviews, (12), CD010378. https://doi.org/10.1002/14651858.CD010378.pub2

Protocol ID

890301

Variables

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX890301_Prophylactic_Transfusion_During_Pregnancy_Adverse_Event
	PX890301130000	Adverse Events/Transfusion Reactions	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Adverse_Event_AI
	PX890301130200	Adverse Events/Transfusion Reactions more Alloimmunization ______________________________________________________ show less	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Adverse_Event_DHTR
	PX890301130300	Adverse Events/Transfusion Reactions Delayed more Hemolytic Transfusion Reaction ___________________________________ show less	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Adverse_Event_Yes
	PX890301130100	Adverse Events/Transfusion Reactions Yes, more Number of Reactions _____ show less	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Freq
	PX890301030000	Transfusion Frequency	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Freq_Other
	PX890301030100	Transfusion Frequency Other _________	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Hb
	PX890301050000	Hb Target ___ g/L	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Hbs
	PX890301060000	HbS Target ___ %	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Number
	PX890301110000	Number of Transfusions _____	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Post_Hb
	PX890301100000	Post-Transfusion Hb _____ g/L	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Pre_Hb
	PX890301090000	Pre-Transfusion Hb _____ g/L	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Pre_Hbs
	PX890301070000	Pre-Transfusion HbS _____%	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Schedule
	PX890301010000	Transfusion Schedule	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Timing_First
	PX890301040000	Timing of First Transfusion ____ weeks more Gestational Age show less	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Type
	PX890301020000	Transfusion Type	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy_Units
	PX890301120000	Number of Units Transfused _____	N/A
PX890301_Prophylactic_Transfusion_During_Pregnancy__Post_Hbs
	PX890301080000	Post-Transfusion HbS _____%	N/A

SCD Pregnancy

Measure Name

Prophylactic Transfusion During Pregnancy

Release Date

August 5, 2024

Definition

Prophylactic red blood cell transfusions can reduce complications in pregnant people with sickle cell disease by correcting severe anemia and the extent of vaso-occlusion in both the maternal and placental circulations. 

Purpose

Prophylactic transfusions in pregnant people with sickle cell disease (SCD) may reduce maternal mortality, vaso-occlusive pain events, pulmonary complications, and pre-term birth and perinatal mortality. Preventive transfusions (in the absence of complications) starting in the early weeks of pregnancy or on-demand transfusions (strictly for medical/obstetric indications) are both used to manage these cases. Further research is needed to determine whether the benefits of prophylactic transfusions outweigh the risks. This case report form captures data for the study of transfusion therapy in pregnant people with SCD.

Keywords

sickle cell disease, SCD, transfusion, pregnancy, prophylactic transfusion

Measure Protocols

Protocol ID	Protocol Name
890301	Prophylactic Transfusion during Pregnancy

Publications

There are no publications listed for this protocol.