Does current evidence support the use of intraoperative cell salvage in reducing the need for blood transfusion in caesarean section?

Research output: Contribution to journalReview articlepeer-review

Authors

  • Sukhjit K. Dhariwal
  • Khalid S. Khan
  • Shubha Allard
  • Matthew Wilson
  • Philip Moore
  • Samantha Parker
  • Steve Robson
  • Mairi Harkness
  • Gao Smith Fang
  • Richard Hooper
  • Ian Wrench
  • Aarti Ullal
  • Paul Ayuk
  • Tommy Mousa
  • Matthew Hogg
  • Dominika Dabrowska
  • Chris Marsh
  • Vinod Patal
  • Nicola Osborn
  • Daryl Thorp-Jones
  • Vicki Clark
  • Arlene Wise
  • Sue Catling
  • Susan Williams
  • Jules Allt
  • James Geoghegan
  • David Portch
  • Bini Ajay
  • Lesley Woods
  • George Bugg
  • Sangeeta Pathak
  • Balaji Packianathaswamy
  • Parijat Bhattacharjee
  • Jag Samra
  • Sanjay Rao
  • Isobel Gardner

Colleges, School and Institutes

External organisations

  • King's College London
  • St. George's Healthcare National Health Service Trust
  • Sheffield University
  • Gloucestershire Hospitals NHS Foundation Trust

Abstract

Purpose of review: An important cause of maternal morbidity and direct maternal death is obstetric haemorrhage at caesarean section. Concerns regarding allogeneic blood safety, limited blood supplies and rising health costs have collectively generated enthusiasm for the utility of methods intended to reduce the use of allogeneic blood transfusion in cases of haemorrhage at caesarean section. This can be achieved by intraoperative cell salvage (IOCS). The aim of this review is to summarize and examine the evidence for the efficacy of IOCS during caesarean section, in women at risk of haemorrhage, in reducing the need for allogeneic blood transfusion. Recent findings: The majority of the evidence currently available is from case reports and case series. Although this evidence appears to support the use of IOCS in obstetrics, strong clinical evidence or economic effectiveness from clinical trials are essential to support the routine practice of IOCS in obstetrics. Summary: Current evidence is limited to reported case series and two small controlled studies. Overall, IOCS may reduce the need for allogeneic blood transfusions during caesarean section. Future large randomized trials are required to assess effectiveness, cost effectiveness and safety. The results of the current ongoing SALVO (A randomised controlled trial of intra-operative cell salvage during caesarean section in women at risk of haemorrhage) trial will shed light on these aspects.

Details

Original languageEnglish
Pages (from-to)425-430
Number of pages6
JournalCurrent Opinion in Obstetrics and Gynaecology
Volume26
Issue number6
Publication statusPublished - 1 Dec 2014

Keywords

  • Allogeneic blood transfusion, Caesarean section, Intraoperative cell salvage, Obstetrics

ASJC Scopus subject areas