Red blood cell salvage during obstetric hemorrhage.
OBJECTIVE
To describe which obstetric patients lose enough blood during postpartum hemorrhage to receive a reinfusion of intraoperative blood salvage.


METHODS
Eight years of intraoperative blood salvage data from a regional tertiary care maternity hospital were analyzed. The volume of blood returned through intraoperative blood salvage was standardized to the volume of red blood cells in an allogeneic red blood cell unit from the blood bank.


RESULTS
There were 884 obstetric hemorrhage cases in which intraoperative blood salvage was utilized. Sufficient blood was collected by intraoperative blood salvage to permit reinfusion in 189 of 884 (21%) patients. For patients in whom intraoperative blood salvage blood was reinfused, the mean ± standard deviation number of reinfused shed blood units was 1.2 ± 1.1 units. Although intraoperative blood salvage was most commonly performed on patients who underwent routine cesarean delivery (748/884 patients), only 13% of these patients received an intraoperative blood salvage reinfusion; 73% of the patients undergoing cesarean hysterectomy, 69% of those who had bleeding after cesarean delivery, and 53% of the patients who bled after vaginal delivery received an intraoperative blood salvage reinfusion (P<.001).


CONCLUSIONS
Although intraoperative blood salvage was attempted on many patients, on only 21% of the women was a sufficient amount of intraoperative shed blood collected to proceed with reinfusion. Patients who experienced bleeding or who underwent a cesarean hysterectomy were the most likely to receive a reinfusion of intraoperative blood salvage-processed blood.
The University of Pittsburgh School of Medicine, the Departments of Pathology, Anesthesiology, and Bioengineering, University of Pittsburgh, the Institute for Transfusion Medicine, and the Department of Anesthesiology, Magee-Women's Hospital of UPMC, Pittsburgh, Pennsylvania.
Megan E
ME
Milne
Mark H
MH
Yazer
Jonathan H
JH
Waters
D000328:Adult; D001804:Blood Transfusion, Autologous; D001810:Blood Volume; D002585:Cesarean Section; D004912:Erythrocytes; D005260:Female; D006801:Humans; D007044:Hysterectomy; D057725:Operative Blood Salvage / Q000191:economics; D019106:Postoperative Hemorrhage / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy