ABSTRACT
【Objective】 To determine the rare ABO blood subgroups rapidly and ensure the blood transfusion safety of five patients by a series of serological tests and family investigation, as their preliminary serological results of ABO blood grouping was inconsistent. 【Methods】 ABO blood grouping, antibody screening and Coombs′ tests were performed by the routine serological methods, including manual tube and automatic blood group analyzer, which had matched micro-column gel cards from Diagnostic Grifols. Polymerase chain reaction (PCR) was used to amplify the 6 and 7 exons as well as their adjacent intron region of ABO gene. The patients and their relatives′ ABO blood group and subgroup were analyzed and identified through the comparison with serological phenotype database of ABO blood group. The products of PCR were sequenced directly, and the gene mutation was identified through the comparison with the Blood Group Antigen Gene Mutation Database. 【Results】 Whether micro-column gel cards or manual tube test, the forward and reverse tests of serological grouping were not supported by each other on the five patients′ ABO blood grouping. The forward tests of patients No.1~3 showed AwB phenotype and the reverse tests showed B group. No.4 patient was the forward ABw phenotype and the reverse A group, and No.5 patient was the forward normal AB phenotype and the reverse B group, respectively. All of 5 patients′ Rh C/D/E blood grouping showed clearly; the IDT test and antibody screening result of patient No.1 was positive, while the antibody screening result of patient No.4 was negative. 【Conclusion】 The blood group serological characterization of patient No.1~3 met B(A) blood group, and patient No.4~5 met CisAB blood group. These tests can make a preliminary diagnosis of blood group phenotype, which are verified correctly via blood group genotype.
ABSTRACT
Objective Preoperative preparation of blood is common.The preoperative blood ordering and transfusion practices for elective obstetric surgery were evaluated in our Renji hospital in order to develop a reasonable preoperative blood preparation schedule for those procedures where a cross-match appears necessary.Methods We evaluated blood ordering practices in total 16 232 elective obstetric surgeries in our hospital from January 1,2013 to June 30,2017 retrospectively.The age of patients,preoperative diagnosis,surgical procedures type,preparation volume of blood,intra-operative transfusion volume of blood,and excessive usage ratio of blood were calculated and analyzed.Results 455 patients transfused intraoperatively total 1 610 U red blood cells.The usage ratio of blood was 2.80％ for patients and 4.87％ for blood preparation volumes respectively.Placenta previa,ectopic pregnancy,twin pregnancy accounted for the first three of the possibility of intraoperative blood transfusion in obstetric surgeries.Conclusion The relationship between preoperative diagnosis and the risk of blood transfusion in obstetric surgery should be take attention to.Preoperative blood typing,antibody screening and appropriate cross-matching could ensure the safety of obstetric surgery.