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Intraoperative cell salvage is associated with reduced allogeneic blood requirements and has no significant impairment on coagulation function in patients undergoing cesarean delivery: a retrospective study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

The aim of the study is to examine the association between Intraoperative cell salvage (ICS), allogeneic blood transfusion (ABT) and coagulation function in obstetrics.

Methods

A total of 486 pregnant women undergoing cesarean delivery, of whom 157 were enrolled in this retrospective study. Patients were divided into ICS group (n = 101, ICS used during operation) and control group (n = 56, ICS not used during operation). Clinical data, including plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and thrombin time (TT) levels, were collected from all patients preoperatively (within 12–24 h) and postoperatively (within 6–12 h) and analyzed by t test, two-way repeated-measures ANOVA and Spearman’s correlation.

Results

The use of ICS is associated with lower requirement rate for ABT (P < .001), while the blood loss was similar between the two groups (P = .990). Mean volume of ICS transfusion was 432.65 mL. Compared to preoperative values, the postoperative PT and APTT levels were significantly increased, while Fib was decreased in the two groups (all P < .01). No significant difference in coagulation function was observed between groups in preoperative and postoperative phase (P > .05). Furthermore, PT, APTT and TT after surgery were not correlated with the transfused volume of salvaged blood (P > .05) while the levels of Fib were negatively correlated with the volume (P < .01). In addition, there were no transfusion reactions in both two groups.

Conclusions

Intraoperative cell salvage is correlated with reduced allogeneic blood requirements but did not impair blood coagulation significantly in patients undergoing cesarean delivery.

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Abbreviations

ABT:

Allogeneic blood transfusion

ICS:

Intraoperative cell salvage

PT:

Prothrombin time

APTT:

Activated partial thromboplastin time

Fib:

Fibrinogen

TT:

Thrombin time

FP:

Frozen plasma

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Funding

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Author information

Author notes

  1. Ruihan Wang and Ting Luo contributed to the work equally and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Blood Transfusion, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, People’s Republic of China

    Ruihan Wang, Jinbo Fan, Guojun Zhou & Jiubo Liu

  2. Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, People’s Republic of China

    Ting Luo & Anshi Wu

  3. Department of Forensic Medicine, Hubei University of Medicine, Shiyan, Hubei, People’s Republic of China

    Zhiwei Liu

Authors
  1. Ruihan Wang
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  2. Ting Luo
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  3. Zhiwei Liu
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  4. Jinbo Fan
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  5. Guojun Zhou
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  6. Anshi Wu
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Contributions

RW helped design the study, collect and analyze the data, and write the article; TL helped design the study, write and revise the manuscript; ZL helped analyze the data and write the article; JF helped conduct the study and collect the data; GZ helped conduct the study and collect the data; JL helped design the study, collect the data, and approved the final manuscript; AW helped design the study, analyze the data, and approved the final manuscript.

Corresponding authors

Correspondence to Anshi Wu or Jiubo Liu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. (And/or in case humans were involved.) This study was approved by the ethical committee of Taihe Hospital, and the requirement for written informed consent was waived by the Institution review board. This manuscript follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.

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Wang, R., Luo, T., Liu, Z. et al. Intraoperative cell salvage is associated with reduced allogeneic blood requirements and has no significant impairment on coagulation function in patients undergoing cesarean delivery: a retrospective study. Arch Gynecol Obstet 301, 1173–1180 (2020). https://doi.org/10.1007/s00404-020-05500-x

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  • DOI: https://doi.org/10.1007/s00404-020-05500-x

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