Women who decline blood during labour: Review of findings and lessons learnt from 52 years of Confidential Enquiries into maternal mortality in the United Kingdom (1962-2019).

Objective: Patients who decline blood products because of their religious beliefs pose a unique challenge in the context of obstetric haemorrhage. Four large series assessing maternal outcomes in Jehovah's Witnesses from USA, UK, Netherlands and Japan estimate that maternal mortality is increased by between 44 and 160-fold. A review of maternal deaths from obstetric haemorrhage was undertaken in mothers who decline blood transfusion, using UK Confidential Enquiries into Maternal Deaths reports (1967-2019) in order to identify common trends and lessons learnt.

Interventions for improving adherence to iron chelation therapy in people with sickle cell disease or thalassaemia.

Background: Regularly transfused people with sickle cell disease (SCD) and people with thalassaemia (who are transfusion-dependent or non-transfusion-dependent) are at risk of iron overload. Iron overload can lead to iron toxicity in vulnerable organs such as the heart, liver and endocrine glands; which can be prevented and treated with iron chelating agents. The intensive demands and uncomfortable side effects of therapy can have a negative impact on daily activities and well-being, which may affect adherence.

Interventions for improving adherence to iron chelation therapy in people with sickle cell disease or thalassaemia.

This is the protocol for a review and there is no abstract. The objectives are as follows: To identify and assess the effectiveness of interventions to improve adherence to iron chelation therapy compared to standard care in people with SCD or thalassaemia including: identifying and assessing the effectiveness of different types of interventions (psychological and psychosocial, educational, medication interventions, or multi-component interventions);identifying and assessing the effectiveness of interventions specific to different age groups (children, adolescents, adults).

Assessment of anaemia in elective pre-operative orthopaedic patients.

The transfusion of components made from human blood carries a small risk to the recipient. Pre-operative preparation, ensuring that the patient is not anaemic before surgery, is important to ensure that blood is not transfused unnecessarily. This article highlights that pre-operative anaemia is often not effectively managed in patients presenting for elective total hip replacement surgery, putting them at risk of unnecessary transfusion.

Observer accuracy and reproducibility of visual estimation of blood loss in obstetrics: how accurate and consistent are health-care professionals?

Objectives: To evaluate the observer accuracy and intra-observer test-retest reliability of visual estimation of blood loss by midwives and obstetricians.

Methods: This was a prospective, single-blinded observational study conducted at a London teaching hospital. The accuracy of visually estimating five maternity pads that had been soaked with 25, 50, 100, 150 and 200 ml of blood was assessed.

A home blood transfusion programme for beta-thalassaemia patients.

Although home transfusion programmes are relatively common in the USA (Anon, 1990, Home Care in the 1990s. Council on Scientific Affairs. Journal of the American Medical Association, 263, 1241-1244), this type of treatment has only recently been considered in Britain and, where it is in operation, is generally supervised by trained nursing staff or via a hospice.