Peripartum use of cell salvage: a university practice audit and literature review

Abstract

Obstetrical hemorrhage is the second leading cause of direct maternal mortality (18% of maternal deaths) in developed countries and is the leading cause of severe maternal morbidity. The rising rate of obstetrical hemorrhage attributed to the repeated cesarean sections and invasive placental disorders, requiring blood transfusion has emphasized the need for alternatives to allogeneic blood donation. The Shaare Zedek Medical Center is a teaching hospital with the largest obstetric service in the region-13,500 live births per year. The medical records of all parturients requiring use of intraoperative cell salvage system (IOCS) (2007-2011) were reviewed to evaluate our experience with this unique system and possible complications in the obstetrical milieu of a large obstetric unit. Using our combined medical records, we found that IOCS is a rapid method of blood replacement that allows blood bank service recruitment and presents no adverse reaction to the parturient. However, this sophisticated system is appropriate for tertiary surgical centers and its routine use should be assessed by national medical boards.