Safety of intraoperative autologous blood collection and autotransfusion during cesarean section (c s)

OBJECTFVE: To evaluate the safely of inlraoperative antologoiis blood collection and autotransfusion during CS complicated bv massive hemorrhage. STUDY DESIGN: 236 cases with plaeenla previa (PP). placcnial abrup(ion. disseminated intravascular <oagnlopaih (DIC), or cesarean hvsterecioniv (CH) were reviewed from 1988 to 1991) at Vale New Haven Hospital. Eight cases of seven- intraoperative hemorrhage, autologous blood colleclion using t lie Cell Save? 3 plus®, arid aulo transfusion u ere identified as the studv group(S). These eases were compared to a rontiu! groujj (c.) of M patients who received heierologous blood translusion during similar surgical procedures Statistics were performed bv Mann-Whitne L' Test and Fischer's Exact Test as appropriate. P < 0.05 wa.s significant. RESULTS: In S. all patients were diagnosed with complete I'P uilh a mean ol 2.25 previous ('- S (range: l-:î). 7 patients had CH and I underwent pelvic arterv ligation (PAL). The median anlotransliision volunu1 was TOOcc (range: :i")()cc-7,000cc). The mean autotransfusion volume as a proportion of total red blood cell (RBC1 volumt1 transfused was !UH'?. In C.. 7 paiieni.s had PP. !i had uterine atom. 3 had uterine rupture, and 1 had placental bed hemorrhage. VI patients had CII. 1 had PAL. and I had CS alone. Total RB(1 transfusion volume was median: 19ZVc (range: 700cc-Hi.800cc) and mean: 3700cc. All patients in both groups reeened postpanum antibiotics. There was no significant différence between the two groups in the incidence of DIC. need for ventilating support, or the length of postpanum hospitaliation. There was no case of Acute Respiralon Distress Sndnnne (ARI)S) 01 Amniotic Fluid Embolism (AKK) in either grou]). CONCLUSIONS: Despite the theoretical risk of autolranslu.sion of blood CMI laminated b amniotic fluid at (VS. thei e u as no itu i'eased incidence of postpanum ((implications. In this preliminary expeiienre. antotratT-fusion appears to be a safe technique in the management of intraopeiative obstetrical hemorrhage.