Author:
Rong Xiaoying,Guo Xiangyang,Zeng Hong,Wang Jun,Li Mi,Wang Yang
Abstract
Abstract
Background
The guidelines of National Health Service(NHS, the United Kingdom) recommended for use in obstetrics at increased risk of bleeding, requiring two suction devices to reduce amniotic fluid contamination, however, when comes to massive hemorrhage, it is may difficult to operate because the complex operation may delay time. The aim of the study was to detect the effect of amniotic fluid recovery on intraoperative cell salvage in obstetrics and provide evidence for clinical applications.
Method
Thirty-four patients undergoing elective cesarean section were randomly divided into two groups. In group 1, the cumulative blood from the operation field, including the amniotic fluid, was collected using a single suction device for processing. In group 2, after suctioning away the amniotic fluid using another suction device for the cumulative blood from the operation field. From each group, four samples were taken, including maternal venous blood (sample I), blood before washing (sample II), blood after washing (sample III) and blood after filtration with a leukocyte filter (sample IV), to detect serum potassium (K +), hemoglobin (Hb), white blood cell (WBC), fetal hemoglobin (HbF), alpha fetoprotein (AFP) and squamous cell (SC) levels.
Results
The AFP, K + and WBC levels of sample III and sample IV were significantly lower than sample I in group 1 and group 2 (P < 0.05). Significantly more SCs were found in sample III than in sample I in group 1 and group 2 (P < 0.05), but SCs of sample IV had no statistical difference compared to sample I in group 1 and group 2 (P > 0.05). There was no significant difference in the K + , Hb, WBC, AFP and SC levels of sample IV between group 1 and group 2 (P > 0.05). The HbF levels of sample III and sample IV were significantly higher in group 1 than in group 2 (P < 0.05).
Conclusion
There is little or no possibility for AF contamination to enter the re-infusion system when used in conjunction with a leucodepletion filter. For maternal with Rh-negative blood, we recommend two suction devices to reduce HbF pollution.
Trial registration
ChiCTR1800015684, 2018.4.15.
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology
Reference24 articles.
1. Klein A A, Bailey C R, Charlton A J, et al. Association of Anaesthetists guidelines: cell salvage for peri-operative blood conservation 2018. Anaesthesia. 2018;73(9):1141–50.
2. Catling S. Intraoperative cell salvage in obstetrics. Clin Risk. 2008;14:14–7.
3. Durand F, Duchesne-Gueguen M, Le Bervet JY, Marcorelles P, Tardivel R, Vovan JM, Le Goff MC, Genetet B. Rheologic and cytologic study of autologous blood collected with Cell Saver 4 during cesarean. Rev Fr Transfus Hemobiol. 1989;32:179–91.
4. Thornhill ML, O’Leary AJ, Lussos SA, Rutherford C, Johnson MD. An in-vitro assessment of amniotic fluid removal from human blood through cell saver processing. Anesthesiology. 1991;75(Suppl 3):A830.
5. Elagamy A, Abdelaziz A, Ellaithy M. The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation[J]. Int J Obstet Anesth. 2013;22(4):289–93.