Role of Acute Normovolemic Hemodilution in Pregnancy for Emergency Cesarean Section in a Patient With Bombay Blood Group

Postpartum hemorrhage (PPH) is among the leading causes of maternal morbidity and mortality, and various blood conservation strategies can be implemented to minimize blood loss. Acute normovolemic hemodilution (ANH) is a simple yet effective blood management tool in the armamentarium of an anesthesiologist, the use of which can be considered for patients undergoing surgical procedures with inherent bleeding risks, procedures where more than 50% of the patient’s circulating blood volume is lost, patients with multiple antibodies and rare blood groups, and those unwilling to undergo an allogenic blood transfusion. We hereby describe the performance of ANH in a pregnant woman with a Bombay blood group during an emergency cesarean section. Existing literature on ANH in obstetric patients does not report adverse fetal or maternal outcomes due to preoperative blood donation and advocates its selected use in situations where the benefits outweigh the risks.