Intraoperative cell salvage in obstetrics

Clin Risk 2008;14:14-17
doi:10.1258/cr.2007.070009
© 2008 Royal Society of Medicine Press

 

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Intraoperative cell salvage in obstetrics

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Dr Sue Catling

Email: sue.catling{at}btopenworld.com

Cell salvage is widely used in many surgical specialties toreduce the use of allogeneic blood, which is associated withwell-recognized significant complications such as incorrecttransfusion, acute and delayed immunological transfusion reactionsand transfusion-transmitted infection. Theoretical concernsover the use of cell salvage in obstetrics have focused on therisk of Rhesus immunization and the risk of contamination ofthe cell-saved blood with traces of amniotic fluid. This articleexamines the in vitro and in vivo evidence for the safety ofthe technique, presents current usage figures from Wales andthe entire UK, and discusses the current perception of amnioticfluid embolus as an anaphylactoid reaction. It suggests thatpatients will have to choose between the risks of allogeneicor cell-saved blood, and concludes that the balance of evidenceis now in favour of cell salvage in obstetrics.

Intraoperative cell salvage in obstetrics
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