❓ A parliamentary question regarding the practice of routinely taking blood from women in labour at Kaleeya Hospital, and whether this practice is consistent across other WA public maternity facilities. The answer confirms the practice at Kaleeya and explains the rationale, while noting it's not routine elsewhere.
AnsweredQoN 3798Legislative Assembly
QuestionView source ↗
(1) Will the Minister confirm whether Kaleeya Hospital is routinely taking blood from all women presenting to the hospital in labour, including those regarded low-risk and from common blood groups, irrespective of whether they pose a high-risk birth or are from a rare blood group; and
(a) if yes, please provide the clinical evidence which demonstrates why this practice is deemed necessary and desirable?
(2) Is this same practice of taking blood from all women presenting in labour also undertaken at Western Australia’s other public maternity hospital facilities?
(a) if yes, please provide the clinical evidence which demonstrates why this practice is deemed necessary and desirable?
(2) Is this same practice of taking blood from all women presenting in labour also undertaken at Western Australia’s other public maternity hospital facilities?
AnswerView source ↗
Answered
12 October 2010
Responded by
Minister for Health
Response time
35 days
(1) Yes, as requested by medical staff.
(a) Obstetric cases often have a high likelihood of blood loss despite the mitigation and management of controllable factors. Primary post-partum haemorrhage occurs in 3.9%-6.4% of deliveries
1
, and 2/3 cannot be predicted
2
. The amount and rate of blood loss varies and this can lead to unexpected and urgent need for blood products.
To mitigate risk a policy has been implemented at Kaleeya Hospital that all women are required to have a group and hold blood sample taken at the time of birthing. This is to be transported over to Fremantle Hospital within two hours of arrival or immediately if birth is imminent.
Notes
1. KEMH clinical guidelines 9.1.1 Primary post partum haemorrhage (2004).
2. Framework for prevention, early recognition and management of postpartum haemorrhage, NSW Health Department (2002).
(2)
South Metropolitan Area Health Service
No, the policy is specific to each maternity hospital and is determined by the availability of a blood bank on site or close proximity to the facility. Kaleeya Hospital does not have a blood bank on site.
North Metropolitan Area Health Service
King Edward Memorial Hospital, Swan Kalamunda Health Service and Osborne Park Hospital do not routinely take blood from low risk women presenting to the hospital in labour.
Samples will be drawn, with the patient's consent, when an intervention is required such as an intravenous line or epidural analgesia or where there are associated risks to the confinement.
WA Country Health Service
The collection of blood is not routinely taken from women presenting in labour at WA Country Health Service hospitals.
In country hospitals maternity clients will have blood taken if they have no antenatal documentation related to blood group, rhesus status, haemoglobin level and antibody status. They may also have blood taken if there is an indication of high risk or the level of medical intervention escalates.
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(a) Obstetric cases often have a high likelihood of blood loss despite the mitigation and management of controllable factors. Primary post-partum haemorrhage occurs in 3.9%-6.4% of deliveries
1
, and 2/3 cannot be predicted
2
. The amount and rate of blood loss varies and this can lead to unexpected and urgent need for blood products.
To mitigate risk a policy has been implemented at Kaleeya Hospital that all women are required to have a group and hold blood sample taken at the time of birthing. This is to be transported over to Fremantle Hospital within two hours of arrival or immediately if birth is imminent.
Notes
1. KEMH clinical guidelines 9.1.1 Primary post partum haemorrhage (2004).
2. Framework for prevention, early recognition and management of postpartum haemorrhage, NSW Health Department (2002).
(2)
South Metropolitan Area Health Service
No, the policy is specific to each maternity hospital and is determined by the availability of a blood bank on site or close proximity to the facility. Kaleeya Hospital does not have a blood bank on site.
North Metropolitan Area Health Service
King Edward Memorial Hospital, Swan Kalamunda Health Service and Osborne Park Hospital do not routinely take blood from low risk women presenting to the hospital in labour.
Samples will be drawn, with the patient's consent, when an intervention is required such as an intravenous line or epidural analgesia or where there are associated risks to the confinement.
WA Country Health Service
The collection of blood is not routinely taken from women presenting in labour at WA Country Health Service hospitals.
In country hospitals maternity clients will have blood taken if they have no antenatal documentation related to blood group, rhesus status, haemoglobin level and antibody status. They may also have blood taken if there is an indication of high risk or the level of medical intervention escalates.
Notice: This document is created or edited using unregistered or evaluation copy of rtLib valid for testing or development purposes only. To use it for productive or any other purposes please register it. You may purchase the license on
http://www.rtlib.com
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