The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation

Elagamy, A.; Abdelaziz, Ahmed; Ellaithy, Mohamed

doi:10.1016/j.ijoa.2013.05.007

Cited by 43 publications

(24 citation statements)

References 27 publications

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“…83,84 Whilst cell salvage and retransfusion are viewed as relatively expensive and labor intensive, autologous cell salvage is now being adopted in many obstetric centers managing PAS disorders, with observational studies showing improved outcomes and reduced need for allogenic blood transfusion, without an increase in adverse outcomes. [84][85][86] Regarding cost analysis, a recent study demonstrated that intraoperative cell salvage during cesarean delivery for invasive placentation justified its use where the probability of requiring packed red cell transfusion of two units was 75%. 87 It is important that suctioned contaminants are kept to an absolute minimum, including amniotic fluid, vernix, microorganisms, fetal blood, and exogenous surgical solutions such as contemporary hemostatics.…”

Section: Cell Salvagementioning

confidence: 99%

FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management,

Allen

Jauniaux

Hobson

et al. 2018

Intl J Gynecology & Obste

277

282

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Section: Cell Salvagementioning

confidence: 99%

FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management,

Allen

Jauniaux

Hobson

et al. 2018

Intl J Gynecology & Obste

277

282

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“…Elagamy et al conducted a prospective observational study on 41 patients with placenta accreta and the role of cell saver technology in reducing allogenic transfusion (24). They found that their cell saver cohort that the mean volume of re-infused salvaged blood was 1476 cc and that 87% of their cohort did not require allogenic red blood cell transfusion.…”

Section: Managementmentioning

confidence: 99%

Placenta accreta: diagnosis, management and the molecular biology of the morbidly adherent placenta

Goh

Žalud

2015

The Journal of Maternal-Fetal & Neonatal Medicine

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Placenta accreta is now the chief cause of postpartum hemorrhage resulting in maternal and neonatal morbidity. Prenatal diagnosis decreases blood loss at delivery and intra and post-partum complications. Ultrasound is critical for diagnosis and MRI is a complementary tool when the diagnosis is uncertain. Peripartum hysterectomy has been the standard of therapy but conservative management is increasingly being used. The etiology of accreta is due to a deficiency of maternal decidua resulting in placental invasion into the uterine myometrium. The molecular basis for the development of invasive placentation is yet to be elucidated but may involve abnormal paracrine/autocrine signaling between the deficient maternal decidua and the trophoblastic tissue. The interaction of hormones such as Relaxin which is abundant in maternal decidua and INSL4, an insulin like peptide found in placental trophoblastic tissue may play role in the formation of placenta accreta.

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“…[3][4][5] Despite this growing challenge facing obstetrical care providers, there is no clear consensus on the range of effective measures that should be used at the time of caesarean hysterectomy in order to prevent massive blood loss. Though contemporary non-surgical measures such as the administration of tranexamic acid 6,7 and the use of cell-saver equipment 8,9 are both indicated and effective, the optimal method of reducing the principal uterine vascularity during surgery remains elusive. 10 The aim of the present study was to compare surgical outcomes between two devascularization techniques at the time of caesarean hysterectomy in women with pathologically confirmed PAS disorders: prophylactic internal iliac artery surgical ligation (Ligation) and prophylactic preoperative endovascular internal iliac artery balloon placement (Balloon).…”

Section: Introductionmentioning

confidence: 99%

Prophylactic internal iliac artery ligation versus balloon occlusion for placenta accreta spectrum disorders: A retrospective cohort study

Papillon-Smith

Hobson

Allen

et al. 2020

Intl J Gynecology & Obste

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Objective To compare surgical outcomes between women undergoing prophylactic internal iliac artery ligation or preoperative placement of balloon‐occlusive devices at cesarean hysterectomy for placenta accreta spectrum (PAS) disorders. Methods A retrospective cohort study was conducted at a tertiary‐care referral center for PAS disorders in Ontario, Canada. Eligible electronic records were reviewed of women undergoing cesarean hysterectomy for PAS disorders between November 2012 and June 2018. Outcomes for the ligation and balloon groups were compared primarily on procedure‐related complications and secondarily on total procedure time, bleeding and transfusion metrics, and intraoperative and postoperative complications. Results Of the 79 cases of cesarean hysterectomy, 47 underwent balloon placement and 32 underwent ligation. Baseline characteristics between the groups were similar except for more emergency procedures in the ligation group (37.5% vs 12.8%, P=0.014). The balloon‐related complication rate was 5/47 (10.6%), with no reported complications in the ligation group (P=0.077). Procedural time was longer in the balloon group (353 ± 14 vs 227 ± 13 minutes, P<0.001). Estimated blood loss was similar (1874 ± 245 mL vs 1713 ± 181 mL, P=0.590). Conclusion Women undergoing prophylactic placement of endovascular balloons at caesarean hysterectomy for PAS disorders had a 10.6% procedure‐related complication rate and increased total procedure time, with no decrease in blood loss compared to those undergoing surgical ligation.

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The use of cell salvage in women undergoing cesarean hysterectomy for abnormal placentation

Cited by 43 publications

References 27 publications

FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management,

FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management,

Placenta accreta: diagnosis, management and the molecular biology of the morbidly adherent placenta

Prophylactic internal iliac artery ligation versus balloon occlusion for placenta accreta spectrum disorders: A retrospective cohort study

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