Transfusion-related acute lung injury during pregnancy. A case report and literature review

Abstract

Transfusion-related acute lung injury (TRALI) is an uncommon complication, especially in obstetrics. The mortality rate for this event is around 6% and has now become the leading cause of transfusion-related death. TRALI diagnosis criteria have been well established since 2004 and they must be considered for its early identification and treatment. We report a case of a 30-week pregnant woman who suffered a urinary tract infection. She received a blood transfusion with one unit of red blood cells due to having 6.7 gr/dl haemoglobin. One hour later she developed an acute respiratory distress syndrome and required four days' mechanical ventilation. Maternal and neonatal outcome were optimal, leading to complete resolution of respiratory symptoms. This case should be shared to motivate reporting this kind of complication because the influence of pregnancy on TRALI is usually ignored. Furthermore, fluent communication with the blood bank should be established to strengthen the transfusion surveillance system.