Postpartum anemia is a significant contributor to peripartum morbidity. The utilization of cell salvage in low risk cases and its impact on postpartum anemia has not been investigated. We therefore aimed to examine the impact of autologous blood transfusion/cell salvage in routine cesarean delivery on postoperative hematocrit and anemia. Retrospective cohort study from a perfusion database from a large academic center where cell salvage is performed at the discretion of the obstetrical team. Data from 99 patients was obtained. All patients were scheduled elective cesarean deliveries that took place on the labor and delivery floor. Thirty patients in the cohort had access to cell salvage where autologous blood was transfused after surgery. Pre-procedural hemoglobin/hematocrit measurements were obtained along will postpartum samples that were collected on post-partum day one. The median amount of blood returned to cell salvage patients was 250 mL [206–250]. Hematocrit changes in cell salvage patients was significantly smaller than controls (−1.85 [−3.87, −0.925] vs −6.4 [−8.3, −4.75]; p < 0.001). The odds of developing new anemia following surgery were cut by 74% for the cell salvage treatment group, compared to the odds for the control group (OR = 0.26 (0.07–0.78); p = 0.028) Despite losing more blood on average, patients with access to cell salvage had higher postoperative HCT, less postpartum anemia, and no difference in complications related to transfusion. The utilization of cell salvage for routine cesarean delivery warrants further research.

中文翻译：

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细胞挽救对低出血风险择期剖宫产中血细胞比容和产后贫血的影响


产后贫血是围产期发病的一个重要因素。细胞回收在低风险病例中的利用及其对产后贫血的影响尚未得到研究。因此，我们的目的是研究常规剖宫产中自体输血/细胞挽救对术后红细胞压积和贫血的影响。来自大型学术中心的灌注数据库的回顾性队列研究，其中细胞回收由产科团队自行决定。获得了 99 名患者的数据。所有患者都被安排在产房进行选择性剖腹产。该队列中的 30 名患者在手术后获得了细胞回收，即输入自体血液。术前血红蛋白/血细胞比容测量值是根据产后第一天收集的产后样本获得的。返回细胞回收患者的血液量中位数为 250 mL [206–250]。细胞抢救患者的血细胞比容变化显着小于对照组（-1.85 [-3.87, -0.925] vs -6.4 [-8.3, -4.75]；p < 0.001）。与对照组相比，细胞挽救治疗组术后出现新贫血的几率降低了 74%（OR = 0.26 (0.07–0.78)；p = 0.028）尽管平均失血量较多，但患者获得细胞回收的患者术后 HCT 较高，产后贫血较少，且与输血相关的并发症没有差异。将细胞回收用于常规剖腹产值得进一步研究。