Clinical evaluation of reliability of autologous blood withdrawal during cesarean section

Abstract

Objective To evaluate the reliability of autologous blood withdrawal during cesarean section. Methods Fifteen patients preoperatively diagnosed with pernicious placenta previa and/or accrete by using ultrasound and magnetic resonance imaging, aged 20-35 yr, weighing 55-75 kg, at ≥ 36 weeks of gestation, were enrolled in the study.Blood containing amniotic fluid from the surgical field was collected, and the washed blood was processed using cell-salvage machine and then filtered using a leukocyte depletion filter during cesarean section.The 20 ml blood samples collected included maternal central venous blood after delivery of fetus, unwashed blood, washed blood and filtered blood.The fetal squamous cells were counted using papanicolaou staining.The concentrations of a-fetoprotein, tissue factor, endothelin-1 and histamine were measured by enzyme linked immunosorbent assay.The fetal red blood cells were counted using the acid elution method and HE staining. Results Compared with unwashed samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count, concentrations of a-fetoprotein and endothelial-1, and fetal red blood cells were decreased in the washed samples.Compared with washed samples, the fetal squamous cell count, concentrations of a-fetoprotein and fetal red blood cells were significantly decreased in filtered samples.Compared with maternal venous blood samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count and concentrations of a-fetoprotein and endothelial-1 were decreased in filtered samples. Conclusion Autologous blood withdrawn during cesarean section can be used for reinfusion in cesarean section. Key words: Blood transfusion; autologous; Cesarean section