Preventing Alloimmunization in the Trauma Setting: A Case Report and Development of a ultidisciplinary Protocol

Background: Casualties with haemorrhagic shock resuscitated with whole blood showed improved survival compared to individual components. Low Titer Group-O Whole Blood (LTOWB)/preferred fluid resuscitation in combat and trauma in the U.S. LTOWB have potential to sensitize women to RhD antigen, complicating future pregnancies.

Case: Female polytrauma received unit of RhD-positive Low Titer Group-O Whole Blood enroute to hospital. Evaluation confirmed positive pregnancy. Care coordinated by multidisciplinary team consisting of OBGYN, Trauma, Pathology, and Hematology to prevent alloimmunization. Protocol preventing maternal alloimmunization in the setting of trauma developed.

Conclusion: Low Titer Group-O Whole Blood in RhD negative women of reproductive age highlighting importance of utilizing multidisciplinary approach to coordinating care and preventing maternal alloimmunization. Where alloimmunization is unable to be prevented, it’s important to educate about implications of care and risks to future pregnancies.

Author(s): Meghan Munisteri , Rebecca Wong and Veronica Gonzalez Brown

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