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

IF 0.4 4区医学 Q4 OBSTETRICS & GYNECOLOGY

Clinical and experimental obstetrics & gynecology Pub Date : 2022-01-26 DOI:10.31083/j.ceog4902033

Yang Zhang, Weiling Gu, Xi-rong Xiao

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引用次数: 0

Abstract

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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剖宫产患者术中凝血障碍并发血液抢救3例报告及文献复习

背景：术中细胞挽救（ICS）已在1100多例已发表的产科病例中使用，可以有效减少异基因输血的需要。然而，ICS可能导致一种危及生命的凝血病，称为抢救性血液综合征（SBS）。在一些非产科病例中报告了SBS，但在产科患者中很少报告。病例：我们回顾了2018年10月之前发生在我们医院的所有841例细胞野蛮病例。在此，我们报告了3例剖宫产术后接受ICS治疗的患者的凝血障碍。产科SBS在我院的发生率为0.46%。诊断：剖宫产时没有严重出血，我们像往常一样进行了手术止血。然后，在手术后几个小时和ICS后，发生了出血，其中低纤维蛋白原血症比基于产后出血量的预期更严重。此外，还观察到凝血功能相关参数的其他显著变化，包括血小板计数下降以及PT和aPTT水平明显延长。需要对产科SBS进行更具体和深入的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and experimental obstetrics & gynecology 医学-妇产科学

CiteScore

0.50

自引率

0.00%

发文量

241

审稿时长

1 months

期刊介绍： CEOG is an international, peer-reviewed, open access journal. CEOG covers all aspects of Obstetrics and Gynecology, including obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine. All submissions of cutting-edge advances of medical research in the area of women''s health worldwide are encouraged.