International journal of obstetric anesthesia
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Int J Obstet Anesth · Feb 2020
Case ReportsManagement of cesarean delivery in a parturient with sickle cell disease.
Chronic hemolysis and intermittent vaso-occlusion in sickle cell disease can lead to recurrent blood transfusions with related complications such as antibody formation and rarely, life-threatening reactions. We report a case of a parturient who presented with complications of sickle cell disease and who later had fetal compromise that required an emergent cesarean delivery. Complex management decisions were made, aided by technologies such as rotational thromboelastometry, quantitative blood loss analysis and cell salvage.
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Int J Obstet Anesth · Feb 2020
Efficiency of leukocyte depletion filters and micro-aggregate filters following intra-operative cell salvage during cesarean delivery.
Intra-operative cell salvage is not routinely used during cesarean delivery because it is not cost-effective for patients at low risk of hemorrhage and there are theoretical concerns about amniotic fluid embolism. Some guidelines recommend using leukocyte depletion filters to decrease the risk of amniotic fluid embolism before re-infusing salvaged blood, but these filters are not available in Japan. We compared the efficacy and safety of leukocyte depletion and micro-aggregate filters in combination with intra-operative cell salvage during cesarean delivery. ⋯ Leucocyte depletion filters are more effective in removing white blood cells and squamous cells than micro-aggregate filters, and their introduction for intra-operative cell salvage during cesarean delivery should be considered in Japanese clinical practice.