Blood cell salvage during cesarean delivery

OBJECTIVE: To review the use of blood cell salvage performed during cesarean delivery. METHODS: A retrospective review of the case notes of 107 patients who underwent blood cell salvage during cesarean delivery. A total of 102 women at high risk of hemorrhage were prepared preoperatively for cell salvage. A second group of 5 patients had cell salvage initiated intraoperatively owing to unexpected severe hemorrhage. RESULTS: Of the 107 patients, 36 (33.6%) were re-infused with salvaged blood. There were no reported incidents of amniotic embolization or hemolytic disease. Of the 31 patients for whom cell salvage was prepared preoperatively, only 6 patients required transfusion of banked blood. In elective procedures, patients were re-infused with salvaged blood averaging 28% of the volume of blood lost, without complications. CONCLUSION: Cell salvage was acceptable, beneficial, and without adverse events in both high-risk elective cesareans and emergency cesareans for unexpected hemorrhaging. The skills refined during use of cell salvage in elective cesareans were crucial for successful implementation during emergency situations.