Transfusion and Apheresis Science 53 (2015) 288
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Transfusion and Apheresis Science j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / t r a n s c i
My pregnancy in the apheresis unit Anna Colpo * Apheresis Unit, Blood Transfusion Service, University Hospital of Padua, Padua, Italy
Contents Reference .................................................................................. 288
The Apheresis Unit is a multidisciplinary service, and the application of therapeutic apheresis during pregnancy may treat several high-risk conditions, as reviewed by Marson et al. [1] in this issue of the journal. Pregnancy per se is a crucial life transitional event with physical, psychological, relational and emotional changes, with an impact on all aspects of life. Anxiety and concerns about one’s self and the baby are common during pregnancy. However, in highrisk conditions, a pre-existing medical illness or the new onset of a disease in the expectant mother may increase fears and stress. Apart from physiological and pathological knowledge and technical expertise, apheresis unit personnel should deal with the psychological aspect of a high-risk pregnancy. Moreover, in cases of pre-existing conditions in which apheresis treatment might be indicated to mitigate maternal and/or fetal risks, the therapeutic apheresis specialists are involved in pre-conception counseling. For the above mentioned reasons, in this particular patient population, it is very important to establish a positive caring relationship at the beginning of the therapeutic process. My experience as an apheresis physician working during my own pregnancy (Fig. 1) put me in a position to discover an emotional intimacy and empathy with other expectant mothers less fortunate than me. I could thoroughly understand their fears and their uncertainties, in addition to their need to identify credible and similar representative with whom they could establish a positive relationship, based on trust and respect. Pregnancy thereby became a common denominator between the doctor and the patient. Ordinary roles were altered and the physician got closer to the patient through a natural instinct composed of compassion, soli-
Fig. 1. Baby A. at 12 weeks working with her mom in the apheresis unit.
darity and emotional sharing. The experience of pregnancy and subsequent motherhood is a revolution that removes the distance between mothers and emphasizes social and professional instinct of solidarity and collegiality. During that period, I experienced “new eyes” to look at the other mothers-in therapy, and that is the reason why I tried to invest in my institutional role, offering competence, understanding, willingness and support to expectant mothers. At that moment, even more than in the past, competence and compassion were intertwined, I was emptied of my “positions of strength”, acquiring greater affinity with patients. Because at a certain time, when fears increase or when certainties waver, one can feel a kick coming from the womb. And in those moments, moms are moms, whether they are physicians or patients. Reference
* Apheresis Unit, Blood Transfusion Service, University Hospital of Padua, via Giustiniani 2, 35128 Padova, Italy. Tel.: +39 049 8217387; fax: +39 049 8211251. E-mail address:
[email protected]. http://dx.doi.org/10.1016/j.transci.2015.11.009 1473-0502/© 2015 Elsevier Ltd. All rights reserved.
[1] Marson P, Gervasi MT, Tison T, Colpo A, De Silvestro G. Therapeutic apheresis in pregnancy: General considerations and current practice management of severe Rh disease. Transfus Apher Sci 2015;53:256–61.