Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review

Background: Intraoperative cell salvage (ICS) has been used in more than 1100 published obstetrics cases and can reduce the need for allogeneic transfusion effectively. However, ICS could lead to a life-threatening coagulopathy called salvaged blood syndrome (SBS). SBS was reported in several non-ob...

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Main Authors: Yang Zhang, Wei-Rong Gu, Xi-Rong Xiao
Format: Article
Language:English
Published: IMR Press 2022-01-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/49/2/10.31083/j.ceog4902033
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author Yang Zhang
Wei-Rong Gu
Xi-Rong Xiao
author_facet Yang Zhang
Wei-Rong Gu
Xi-Rong Xiao
author_sort Yang Zhang
collection DOAJ
description Background: Intraoperative cell salvage (ICS) has been used in more than 1100 published obstetrics cases and can reduce the need for allogeneic transfusion effectively. However, ICS could lead to a life-threatening coagulopathy called salvaged blood syndrome (SBS). SBS was reported in several non-obstetric cases but has rarely been reported in obstetric patients. Cases: We reviewed all 841 cell savage cases that occurred in our hospital prior to October 2018. Here, we present 3 cases of coagulopathy in patients who received ICS after cesarean section. The rate of obstetrical SBS in our hospital was 0.46%. Dicussion: Cesarean section was performed without severe hemorrhage, and we performed the surgical hemostatic procedures as usual. Then, several hours after the surgery and after ICS, bleeding occurred, in which hypofibrinogenemia was more severe than expected based on the amount of postpartum hemorrhage. In addition, other marked changes in coagulation function-related parameters, including a decline in the platelet count and obvious prolongation of the PT and aPTT levels, were also observed. More specific and in-depth studies concerning obstetric SBS are needed.
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institution Kabale University
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publishDate 2022-01-01
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series Clinical and Experimental Obstetrics & Gynecology
spelling doaj-art-c9d65942f86f4a60a97f49fb5946d4e02025-08-20T03:48:32ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-01-014923310.31083/j.ceog4902033S0390-6663(22)01682-7Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature reviewYang Zhang0Wei-Rong Gu1Xi-Rong Xiao2Obstetrics and Gynecology Hospital of Fudan University, 200090 Shanghai, ChinaObstetrics and Gynecology Hospital of Fudan University, 200090 Shanghai, ChinaObstetrics and Gynecology Hospital of Fudan University, 200090 Shanghai, ChinaBackground: Intraoperative cell salvage (ICS) has been used in more than 1100 published obstetrics cases and can reduce the need for allogeneic transfusion effectively. However, ICS could lead to a life-threatening coagulopathy called salvaged blood syndrome (SBS). SBS was reported in several non-obstetric cases but has rarely been reported in obstetric patients. Cases: We reviewed all 841 cell savage cases that occurred in our hospital prior to October 2018. Here, we present 3 cases of coagulopathy in patients who received ICS after cesarean section. The rate of obstetrical SBS in our hospital was 0.46%. Dicussion: Cesarean section was performed without severe hemorrhage, and we performed the surgical hemostatic procedures as usual. Then, several hours after the surgery and after ICS, bleeding occurred, in which hypofibrinogenemia was more severe than expected based on the amount of postpartum hemorrhage. In addition, other marked changes in coagulation function-related parameters, including a decline in the platelet count and obvious prolongation of the PT and aPTT levels, were also observed. More specific and in-depth studies concerning obstetric SBS are needed.https://www.imrpress.com/journal/CEOG/49/2/10.31083/j.ceog4902033coagulopathycesarean sectionintraoperative cell salvagesalvaged-blood syndrome
spellingShingle Yang Zhang
Wei-Rong Gu
Xi-Rong Xiao
Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review
Clinical and Experimental Obstetrics & Gynecology
coagulopathy
cesarean section
intraoperative cell salvage
salvaged-blood syndrome
title Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review
title_full Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review
title_fullStr Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review
title_full_unstemmed Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review
title_short Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review
title_sort coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section three case reports and a literature review
topic coagulopathy
cesarean section
intraoperative cell salvage
salvaged-blood syndrome
url https://www.imrpress.com/journal/CEOG/49/2/10.31083/j.ceog4902033
work_keys_str_mv AT yangzhang coagulopathycomplicatingintraoperativebloodsalvageinpatientsreceivingcesareansectionthreecasereportsandaliteraturereview
AT weironggu coagulopathycomplicatingintraoperativebloodsalvageinpatientsreceivingcesareansectionthreecasereportsandaliteraturereview
AT xirongxiao coagulopathycomplicatingintraoperativebloodsalvageinpatientsreceivingcesareansectionthreecasereportsandaliteraturereview