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Iron optimisation in pregnancy 

 

Up to 70% of pregnant women in Australia are estimated to be impacted by obstetric iron deficiency (ID), resulting in adverse outcomes for the mother and neonate. 

ID is the most prevalent cause of anaemia, though the two diagnoses are not equal. Consensus statements regarding the optimisation of obstetric ID have been lacking.  

What can you do as a health professional working in the field?

Devised by the Haematology in Obstetrics and Women’s Health (HOW) Collaborative, a multidisciplinary group of healthcare professionals worked together to develop consensus recommendations on optimisation of ID in pregnancy and highlight the non-erythropoietic roles of iron as well as the harmful effects of tissue ID to both mother and infant.

The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to evaluate the levels of evidence and strength of recommendations.  

Recommendations include: 

  • Routine ferritin screening should be performed in all pregnant women (GRADE 1C) at booking and at 24-28 weeks. Repeat testing should be performed at 36 weeks if clinically indicated or if the woman is previously unscreened.
  • ID in pregnancy should be defined as a ferritin level <30µg/L (GRADE 1D).  
  • An appropriate oral iron formulation should be offered as first-line therapy for obstetric ID (GRADE 1B).  
  • Alternate-day oral dosing can be considered to limit side effects in women with obstetric ID (GRADE 2B). 
  • Intravenous iron should be offered to women with ID/IDA who are intolerant of or refractory to oral iron or in the third trimester (GRADE 1B).

We're currently updating the maternity blood management resources available on the Lifeblood site, so watch this space.

 
 
Read full paper
 
 
 
 
 

World Anaemia Awareness Day

A day was marked last month to highlight this major global health issue that can impact nearly one quarter of the world's population.

Anaemia has multiple risk factors and causes, including serious health conditions, and iron deficiency is a major cause both in Australia and internationally.  

Regular menstrual losses, expansion of maternal blood volume during pregnancy, and blood loss during and after childbirth, particularly with postpartum haemorrhage, commonly lead to anaemia and iron deficiency. 

 
 
 
Find out more
 
 
 
 

Product transition updates

Introduction of Beriplex® AU to replace Beriplex® P/N

The transition of Australia's prothrombin complex concentrate (PCC) product,  Beriplex®, is about to start with staggered start dates nationally from the end of March to early May 2025. 

Lifeblood will be running down our inventory of Beriplex® P/N before switching to Beriplex® AU and have communicated with customers/laboratories the details of the transition, including to continue to place orders for Beriplex® P/N until we send notification of the transition in their region. 

Transition to split apheresis cryoprecipitate – now complete for all states 

Lifeblood's inventory of large-dose apheresis cryoprecipitate has been exhausted in all states.  

With the transition complete, we're now supplying only whole blood and split apheresis cryoprecipitate to laboratories. Whole blood or split apheresis cryoprecipitate units are equivalent and interchangeable. The recommended adult dose is 10 units of either presentation. 

Transfusion Service Providers may continue to have a mixed inventory of large dose and split apheresis units until remaining stocks of large-dose units are used. 

     
     
     
    Read full transition details
     
     
     

    Is there a role for AI in transfusion?

    Artificial intelligence (AI) has attracted growing global interest but use in medical settings introduces potential for harm and error as well as significant ethical concerns. Published in Vox Sanguinis are the findings from the 2024 International Congress of the ISBT Clinical Transfusion Working Party workshop which explored the applications, concerns, challenges and potential of AI and machine learning tools across the transfusion chain, in blood banking and clinical transfusion practice, transfusion education and research.   

    An electronic survey of meeting attendees (n=72) found 70% use AI (50% for research, 41% in practice and 35% in education) with only 12% reporting having had specific training or education. Significant risks and concerns identified included misdiagnosis and incorrect treatment due to errors in Al algorithms, lack of transparency of AI decision-making, biased data sets and impact on health inequality, privacy, data security, plagiarism and patient consent.  

    The working group shared concerns related to the accuracy of information provided, over-reliance on AI which could erode clinical expertise and potentially diminish the quality of patient care. The workshop highlighted the need for accessible education and training resources, standards, regulatory frameworks to guide health care organisations and professionals, and rigorous testing for robustness and fairness.   

    The paper provides a concise summary of existing studies on the use of AI tools in blood banking and transfusion practice, including their potential and major limitations faced in real world applications. A review of use of AI for transfusion educators and researchers is also covered.  

     
     
     
    AI in transfusion
     
     
     

    Ready for requesting in 2025

    Do you or your team need to set up BloodSTAR access to request immunoglobin (Ig) products? 

    The National Blood Authority’s (NBA) user tips and support materials (including short instructional videos) can streamline the process for setting up access or for changing your facility.  

    You could share the quick links below with new staff who need BloodSTAR access as part of their role and include them in orientation materials. 

    If you need to access BloodSTAR for more than one workplace, you'll need to add a new user role for each hospital or facility you practice at. 

    For guidance on how to register for BloodPortal and get user access to BloodSTAR, go to the NBA BloodSTAR user tips and support materials.  

    The NBA materials also include a flow chart with a simple step-by-step guide outlining the process for accessing government funded IVIg/SCIg for a patient. 

     
     
     
    Access BloodSTAR
     
     
     

     

    Upcoming webinar

     
     

     

    Unlocking understanding: Red cell genotyping and molecular testing in immunohaematology and transfusion practice   

    Join our Red Cell Reference scientists, Naomi Roots and Glenda Millard, for the first episode: Red cell genotyping and molecular testing -principles and indications.  

    Tuesday 25 March

    1.00-1.45pm (AEDT)

    Register
     
     
     
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    Australian Red Cross Lifeblood
    Level 6, 30 Currie Street, Adelaide SA

    Australian Red Cross Lifeblood strives to be a respected and valued education provider and leader. Through our education program we seek to proactively engage learners, improve the knowledge of clinicians and make a positive difference to clinical practice and patient care. For more information about what we do, email us or follow us on Twitter. 
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