Introduction of cell salvage to a large obstetric unit: the first six months☆

Abstract 

Background

We introduced red-cell salvage to our obstetric unit following a two-month period of training and education. We report a service evaluation of the first six months of activity from May to October 2007.

Methods

The indications for using cell salvage were: placenta praevia, suspected placental abruption, multiple pregnancy, multiple repeat caesarean, previous history of post partum haemorrhage, refusal of blood transfusion, caesarean section at full dilatation, low preoperative haemoglobin and at the discretion of the theatre team.

Results

The cell saver was used for 46 patients with a blood loss (median; range) of 800 (200–2000) mL and a heterologous transfusion rate of 22% (10 cases). Blood was processed and returned in 19 cases of which nine were emergency and 10 elective. The median volume (range) of blood returned was 390 (200–800) mL. For the unit as a whole the percentage of all theatre cases who received a heterologous transfusion fell from 10.2% for the equivalent time period in the preceding year to 7.9% during the six month period that cell salvage was in use (P=0.126, χ²). There were no adverse reactions following the administration of processed blood.

Conclusion

We have successfully introduced cell salvage to our unit in a relatively short period of time and have used it for the largest series of patients reported in the UK.

Keywords: Cell salvage, Obstetric haemorrhage, Caesarean section, Autologous transfusion