Evaluation the application of intra-operative cell salvage in cesarean section based on multicenter data
10.3760/cma.j.cn112141-20210426-00229
- VernacularTitle:基于多中心数据的回收式自体血回输在剖宫产术中的应用评价
- Author:
Bin LYU
1
;
Xinghui LIU
;
Yangyu ZHAO
;
Meng CHEN
;
Daijuan CHEN
;
Xiaojing HU
;
Xirong XIAO
;
Jing HUANG
;
Shaoshuai WANG
;
Qianhua WANG
;
Shuxiang LIU
;
Quanfeng WU
;
Yanyu HONG
;
Lei ZHAO
;
Shanshan ZHAI
Author Information
1. 四川大学华西第二医院妇产科，成都 610041
- Keywords:
Cesarean section;
Blood transfusion, autologous;
Postpartum hemorrhage
- From:
Chinese Journal of Obstetrics and Gynecology
2021;56(8):537-544
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety, efficacy and application indication of intra-operative cell salvage (IOCS) in cesarean section.Methods:A total of 1 265 pregnant women who received IOCS blood transfusion during cesarean section in 11 tertiary A hospitals from August 2016 to January 2019 were collected and divided into <1 500 ml group (796 cases) and ≥1 500 ml group (469 cases) according to the amount of blood loss during cesarean section. The general clinical data, ultrasonic imaging data, perinatal and puerperium indicators were analyzed retrospectively. The risk factors of intraoperative blood loss ≥1 500 mL using IOCS transfusion were analyzed by logistic multivariate regression.Results:(1) A total of 848 001 ml of blood was recovered and a total of 418 649 ml of blood was transfused in 1 265 pregnant women who received IOCS transfusions, which was equivalent to 23 258 U red blood cell suspension, greatly saving medical resources. The intraoperative blood loss in <1 500 ml group and ≥1 500 ml group was 800 ml (300-1 453 ml) and 2 335 ml (1 500-20 000 ml), respectively. No amniotic fluid embolism, severe adverse reactions, shock and death occurred in the two groups. (3) Multivariate regression analysis showed that age ≥35 years ( OR=1.5, 95% CI: 1.1-1.9), prenatal hemoglobin level <110 g/L ( OR=1.7, 95% CI: 1.3-2.2), history of uterine surgery ( OR=1.8, 95% CI: 1.3-2.6), placenta previa ( OR=1.9, 95% CI: 1.1-3.1), placenta accreta ( OR=2.6, 95% CI: 1.8-3.9), blood pool in the placenta ( OR=1.6, 95% CI: 1.1-2.3), abnormal posterior placenta muscle wall ( OR=1.8, 95% CI: 1.2-2.6), placenta projecting to the anterior uterine wall ( OR=3.0, 95% CI: 1.3-7.0) were risk factors for blood loss ≥1 500 ml in obstetric transfusion using IOCS technique, with statistical significance (all P<0.05). Conclusion:IOCS is safe and effective in cesarean section, which could save the medical resources and reduces medical expenses, however, it is necessary to strictly master the application indication.
