Abstract
PurposeTo compare the effect of allogeneic transfusion and acute normovolemic hemodilution (ANH) autologous transfusion in patients undergoing cesarean section.MethodsPatients who underwent cesarean section and received blood transfusion therapy from February 2019 to July 2021 in our hospital were observed and divided into the allogeneic group (n = 55) who received allogeneic transfusion therapy and the autologous group (n = 55) who received ANH autologous transfusion therapy according to the mode of transfusion. Observations included vital signs [heart rate (HR), mean arterial pressure (MAP), stroke volume variation (SVV)], blood routine [red blood cells (RBC), platelets (PLT), hematocrit (HCT), hemoglobin (Hb)], T-cell subsets (CD4+, CD8+, CD4+/CD8+), immunoglobulins (IgA, IgM, IgG), inflammatory factors [C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6], and adverse effects were counted in both groups.ResultsThere was no statistical significance in the intra-group and inter-group comparisons of HR, MAP, and SVV between the two groups before transfusion and transfusion for 10 min (P > 0.05). 5d after operation, the RBC, PLT, HCT, and Hb of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). 5d after operation, the CRP, TNF-α, and IL-6 of the allogeneic group were higher than those before operation, and the autologous group was lower than that of the allogeneic group (P < 0.05). 5d after operation, the CD4+, CD4+/CD8+ of the allogeneic group were lower than before operation, and the CD8+ was higher than before operation. The CD4+ and CD4+/CD8+ of the autologous group were higher than that of the allogeneic group, and CD8+ was lower than that of the allogeneic group (P < 0.05). 5d after operation, the IgA, IgG, and IgM of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). During blood transfusion, there was no significant difference in the adverse reaction rate between the two groups (P > 0.05).ConclusionBoth allogeneic transfusion and ANH autologous transfusion have little effect on the vital signs of patients undergoing cesarean section, but ANH autologous transfusion is more helpful to the stability of blood routine, T-cell subsets, immunoglobulin, and inflammation levels after surgery, which is a safe and effective way of blood transfusion.
Highlights
Cesarean section is an important midwifery procedure in the field of obstetrics
They were divided into the allogeneic group (n = 55) receiving allogeneic transfusion therapy and the autologous group (n = 55) receiving Acute normovolemic hemodilutio (ANH) autologous transfusion therapy according to the mode of blood transfusion
There was no significant difference between the two groups in terms of age, gestational weeks and other general conditions, FIGURE 2 | Effect of different blood transfusion methods on patients’ blood routine. (A) red blood cell (RBC), (B) PLT, (C) HCT, and (D) Hb
Summary
Cesarean section is an important midwifery procedure in the field of obstetrics. It is suitable for cases where the fetus cannot be delivered from the vagina normally, such as cephalopelvic error, birth canal abnormalities, fetal distress, fetal position error, umbilical cord prolapse, history of cesarean section, multiple births, etc. Preoperative blood preparation is an important preoperative preparation for cesarean section. It can effectively reduce the risk of disseminated intravascular coagulation (DIC), shock and even death in patients with cesarean section bleeding. For patients with large blood loss during cesarean section, urgent blood transfusion is often required in clinic, currently, allogeneic blood transfusion is mainly used, but it is associated with postoperative infection, immunosuppression and a poor prognosis [5]. Acute normovolemic hemodilutio (ANH) autologous transfusion is an autologous blood transfusion method in which autologous blood is drawn preoperatively and supplemented with an equal volume of crystal or colloidal fluid, and the patient’s blood loss is combined during the operation to return the autologous blood [6]
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