cellsalvageinobstetrics:

IntraoperativeautologousbloodcollectionandautotransfusionduringcesareansectionMay2014TheprocedureGeogheganJ,DanielsJP,MoorePA,etal.Cellsalvageatcaesareansection:theneedforanevidence-basedapproach.BJOG.2009,116(6):743-747.Question1Howmanywomenhavereinfusedwithsalvagedbloodaroundtheworld?

GeographicmappingofRe-infusionCasesFrom1998to2013,atotalof619

Caseswerereinfused.TherewerenoreportedincidentsofAFEorhemolyticdisease.Question2:

Isitsafe?SpecificconcernsAmnioticfluidembolismHaemolyticdiseaseAmnioticfluid

WatersJH,BiscottiC,PotterPS,PhillipsonE.Amnioticfluidremovalduringcellsalvageinthecesareansectionpatient.Anesthesiology.2000,92(6):1531-1536.

Leukocytedepletionfilteringofcell-salvagedbloodobtainedfromcesareansectionsignificantlyreducesparticulatecontaminantstoaconcentrationequivalenttomaternalvenousblood.HaemolyticdiseaseofthenewbornFetalRBCscannotbedistinguishedfrommaternalRBCsbycellsalvage

machines.Sore-infusingfetalredbloodcellscouldresulthaemolyticdiseasein

futurepregnancies.

(Rhesusfactorincompatibility)Whereintra-operativecellsalvageisusedduringCaesareansectioninDnegative,previouslynonsensitisedwomen,andwherecordbloodgroupisconfirmedasDpositive(orunknown),aminimumdoseof1500IUanti-DIgshouldbeadministeredfollowingthere-infusionofsalvagedredcells,andamaternalsampleshouldbetakenforestimationincasemoreanti-DIgisindicated.*ABOincompatibilityhasnoclinicalsignificance.2014counteractQuestion3Isthereanyguideline?GuidelinesandProgress2005

UK:NICETherearetheoreticalsafetyconcernswhenitisusedinobstetricpractice.2006US:ASAIncasesofintractablehemorrhagewhenbankedbloodisnotavailableorthepatientrefusesbankedblood,intraoperativecell-salvageshouldbeconsideredifavailable.2013UK:NICETraditionallyIntraoperativeCellSalvagewascontraindicatedinobstetrics,however,inlightofnewresearchandexperienceithasbeenproventobesafe.Theend

Cellsalvageinobstetrics:thetimehascome！-----Sue

CatlingSingletonHospital,UK

Thanks.Answer：TheReferencesCountryQuantityofliteratureUK37（57.8%）US11（17.2%）Italy3（4.7%）Australia3（4.7%）France2（3.1%）Belgium2（3.1%）Others6（9.4%）Answer：cellsavermachineMachineCasesCellSaver（USA）293（47.3%）Dideco（Italy）188（30.4%）CATS（USA）78（12.6%）Medtronic（USA）9（1.5%）COBE（USA）2（0.3%）Unkonw49（7.9%）Total619（100%）Answer：IndicationsforcellsalvageindicationscasesPlacentapraevia/accreta431（69.7%）Refusalofbloodtransfusion71（11.4%）Intraoperativebleeding43（6.9%）Multiplerepeatcaesarean27（4.3%）Previoushistoryofpostpartumhaemorrhage22（3.5%）Others25（4.2%）Total619（100%）Answer：PerioperativecomplicationscomplicationscasesHypotension5Urinarytractinfection(fever)2Heparintoxicity1Parietalhaematoma1Acuterespiratorydistresssyndrom1Chestinfection1Long-termcomplications0Answer：LeadingresearchinstitutionsUKSingletonHosp