Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2022; 10(8): 2439-2446
Published online Mar 16, 2022. doi: 10.12998/wjcc.v10.i8.2439
Effect of intraoperative cell rescue on bleeding related indexes after cesarean section
Yu-Fang Yu, Yong-Dong Cao
Yu-Fang Yu, Department of Blood Transfusion, Hai’an People’s Hospital Affiliated to Nantong University, Hai’an 226600, Jiangsu Province, China
Yong-Dong Cao, Department of Clinical Laboratory, Hai’an Qutang Central Health Center, Hai’an 226600, Jiangsu Province, China
Author contributions: Yu YF wrote the manuscript; Cao YD participated in data analysis.
Institutional review board statement: The study was approved by the Ethics Committee of Hai’an People’s Hospital Affiliated to Nantong University.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at yyfang125@163.com.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Fang Yu, MBChB, Technician, Department of Blood Transfusion, Hai’an People’s Hospital Affiliated to Nantong University, No. 17 Zhongba Middle Road, Hai’an 226600, Jiangsu Province, China. yyfang125@163.com
Received: December 1, 2021
Peer-review started: December 1, 2021
First decision: December 27, 2021
Revised: January 12, 2022
Accepted: January 27, 2022
Article in press: January 27, 2022
Published online: March 16, 2022
Processing time: 99 Days and 16.2 Hours
Abstract
BACKGROUND

Obstetric hemorrhage is the leading cause of maternal mortality globally, especially in China. The key to a successful rescue is immediate and rapid blood transfusion. Autotransfusion has become an integral part of clinical blood transfusion, with intraoperative cell salvage (IOCS) being the most widely used.

AIM

To investigate the application of IOCS in cesarean section.

METHODS

A total of 87 patients who underwent cesarean section and blood transfusion in our hospital from March 2015 to June 2020 were included in this prospective controlled study. They were divided into the observation (43 cases) and control (44 cases) groups using the random number table method. The patients in both groups underwent lower-segment cesarean section. The patients in the control group were treated with traditional allogeneic blood transfusion, whereas those in the observation group were treated with IOCS. Hemorheology [Red blood cell count, platelet volume, and fibrinogen (FIB)] and coagulation function (partial prothrombin time, prothrombin time (PT), platelet count, and activated coagula-tion time) were measured before and 24 h after transfusion. In the two groups, adverse reactions, such as choking and dyspnea, within 2 h after cesarean section were observed.

RESULTS

Before and after transfusion, no significant differences in hemorheology and coagulation function indices between the two groups were observed (P > 0.05). About 24 h after transfusion, the erythrocyte count, platelet ratio, and FIB value significantly decreased in the two groups (P < 0.05); the PLT value significantly decreased in the two groups; the activated partial thromboplastin time, PT, and activated clotting time significantly increased in the two groups (P < 0.05); and no statistical differences were observed in hemorheology and coagulation function indices between the two groups (P > 0.05). Furthermore, there was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).

CONCLUSION

In patients undergoing cesarean section, intraoperative cell salvage has a minimum effect on hemorheology and coagulation function and does not increase the risk of amniotic fluid embolism.

Keywords: Intraoperative cell salvage; Cesarean section; Amniotic fluid embolism; Hemorheology; Coagulation function

Core Tip: A total of 87 patients who underwent cesarean section and blood transfusion in our hospital from March 2015 to June 2020 were included in this prospective controlled study. The patients were divided into the observation (43 cases) and control (44 cases) groups using the random number table method. Intraoperative cell salvage (IOCS) was found to have a minimum effect on hemorheology and coagulation function in patients with cesarean section and does not increase the risk of amniotic fluid embolism. These findings indicate that the principle of IOCS should be strictly followed during operation, which is worth promoting.