ABSTRACT

Transfusion was a life-saver in many cases of maternal hemorrhage and of course many infants affected by congenital hemolytic anemia were rescued by exchange blood transfusion. In the ‘developed’ world the availability of antibiotics and blood replacement therapy reduced maternal mortality rates from almost 800 per 100 000 births in the 1920s to less than 20 per 100 000 in the late 1980s. Interest in the therapeutic aspects of blood transfusion was aroused again in the eighteenth century. The London-based obstetrician, James Blundell, observed at first hand the disastrous consequences of obstetric hemorrhage. Unexpected non-fatal immune reactions also occurred and, until the rhesus factor was discovered, many rhesus-negative mothers were adversely affected by transfusion of ABO compatible, but rhesus-positive blood. In the 1980s John Abel’s (modified) technique of plasmapheresis was used to good effect in the treatment of maternal blood and consequent reduction of maternal antibody levels in cases of severe rhesus iso-immunisation.