Mamoru Morikawa1, Akitaka Kuramoto2, Masaki Nakayama3, Hidenori Oguchi4, Masaaki Hasegawa5, Toru Funakoshi6, Seishi Furukawa7, Emi Hirayama8, Takeshi Kanagawa9, Takashi Kaji10, Mayumi Kasai11, Yasuhiro Konishi12, Shin-ichi Yamamoto13, Atsuo Itakura14, Makoto Maeda15, Takao Kobayashi16, Hisanori Minakami17. 1. Department of Obstetrics, Hokkaido University Hospital, Sapporo, Japan. Electronic address: mmamoru@med.hokudai.ac.jp. 2. Department of Obstetrics and Gynecology, Kumamoto City Hospital, Kumamoto, Japan. 3. Department of Obstetrics and Gynecology, Yokohama Rosai Hospital, Yokohama, Japan. 4. Department of Obstetrics and Gynecology, Toyota Memorial Hospital, Toyota, Japan. 5. Department of Obstetrics and Gynecology, Kurashiki Central Hospital, Kurashiki, Japan. 6. Department of Obstetrics and Gynecology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan. 7. Department of Obstetrics and Gynecology, Miyazaki University Hospital, Miyazaki, Japan. 8. Department of Obstetrics and Gynecology, Sapporo City Hospital, Sapporo, Japan. 9. Department of Obstetrics and Gynecology, Osaka University Hospital, Suita, Japan. 10. Department of Obstetrics and Gynecology, Tokushima University Hospital, Tokushima, Japan. 11. Department of Obstetrics and Gynecology, Iwate Prefectural Central Hospital, Morioka, Japan. 12. Department of Obstetrics and Gynecology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan. 13. Department of Obstetrics and Gynecology, Kariya Toyota General Hospital, Kariya, Japan. 14. Department of Obstetrics and Gynecology, Juntendo University Hospital, Tokyo, Japan. 15. Department of Obstetrics and Gynecology, Mie Chuo Medical Center, Tsu, Japan. 16. Department of Obstetrics and Gynecology, Hamamatsu Medical Center, Hamamatsu, Japan. 17. Department of Obstetrics, Hokkaido University Hospital, Sapporo, Japan.
Abstract
OBJECTIVE: To determine the clinical usefulness of intraoperative cell salvage (ICS) in obstetrics. METHODS: A retrospective analysis was performed using data for 50 patients who had received ICS blood during obstetric surgery at 13 Japanese facilities between January 1, 2007 and December 31, 2013. The frequencies of ICS-associated adverse events, allogeneic blood transfusion (ABT), and preoperative autologous donation (PAD) were assessed. RESULTS: Placenta previa was the indication for ICS in 42 (84%) women. The ICS blood was reinfused in all women (median 366 mL; range 80 to at least 3715). No ICS-associated adverse events occurred. The median estimated blood loss (EBL) was 2171 mL (range 574-47 000); 27 (54%) women lost at least 2000 mL. ABT was not used in 33 (66%) women. Among 26 women who lost at least 2000 mL of blood and were included in analyses, 12 (44%) did not receive ABT. EBL was linearly correlated with the total volume of transfused blood (P<0.001). CONCLUSION: ICS caused no adverse events among women at elevated risk of peripartum hemorrhage and might be safe for use in obstetrics.
OBJECTIVE: To determine the clinical usefulness of intraoperative cell salvage (ICS) in obstetrics. METHODS: A retrospective analysis was performed using data for 50 patients who had received ICS blood during obstetric surgery at 13 Japanese facilities between January 1, 2007 and December 31, 2013. The frequencies of ICS-associated adverse events, allogeneic blood transfusion (ABT), and preoperative autologous donation (PAD) were assessed. RESULTS: Placenta previa was the indication for ICS in 42 (84%) women. The ICS blood was reinfused in all women (median 366 mL; range 80 to at least 3715). No ICS-associated adverse events occurred. The median estimated blood loss (EBL) was 2171 mL (range 574-47 000); 27 (54%) women lost at least 2000 mL. ABT was not used in 33 (66%) women. Among 26 women who lost at least 2000 mL of blood and were included in analyses, 12 (44%) did not receive ABT. EBL was linearly correlated with the total volume of transfused blood (P<0.001). CONCLUSION: ICS caused no adverse events among women at elevated risk of peripartum hemorrhage and might be safe for use in obstetrics.