Pregnant-One of Jehovah's Witnesses
Hello everyone, this is my first time here. I went to see my consultant today and discussed non-blood treatment if I do go into trauma when delivering my baby. Consultant was no help at all. Very dismissive and I really felt that I wasn't in good hands. I am now going to get in touch with The hospital liaison committee and get one of the elders to come with me to the next appointment. My argument against the consultant is that she said when I am in labour they will not be putting any thing in place to help me if I do go into trauma. I will be treated like all the pregnant women, who would take blood. My argument is that: I don't want to work against them, I want the best treatment possible. So why, if they can put something in place to save my life if I do go into trauma, why won't they do it??? Regards Moesha1 p.s. this isnt the last the consultant has heard from me, believe me!
Amniotic fluid removed using leukocyte redution filter
I am concerned that RC does not adequately portray the current use of cell salvage in obstetrics. Amniotic fluid is removed/reduced using a leukocyte reduction filter. In the case of a patient refusing blood transfusions, it remains a viable option. This technique has been emerging for over ten years. In my experience the OB/GYN and Anesthesiologist is glad to have the leukocyte filter fitted cell saver standing by "just in case".
CONCLUSIONS: Leukocyte depletion filtering of cell-salvaged blood obtained from cesarean section significantly reduces particulate contaminants to a concentration equivalent to maternal venous blood.
Amniotic fluid removal during cell salvage in the cesarean section patient.
Waters JH, Biscotti C, Potter PS, Phillipson E.
Departments of General Anesthesiology, Obstetrics and Gynecology, and Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
BACKGROUND: Cell salvage has been used in obstetrics to a limited degree because of a fear of amniotic fluid embolism. In this study, cell salvage was combined with blood filtration using a leukocyte depletion filter. A comparison of this washed, filtered product was then made with maternal central venous blood. METHODS: The squamous cell concentration, lamellar body count, quantitative bacterial colonization, potassium level, and fetal hemoglobin concentration were measured in four sequential blood samples collected from 15 women undergoing elective cesarean section. The blood samples collected included (1) unwashed blood from the surgical field (prewash), (2) washed blood (postwash), (3) washed and filtered blood (postfiltration), and (4) maternal central venous blood drawn from a femoral catheter at the time of placental separation. RESULTS: Significant reductions in the following parameters were seen when the postfiltration samples were compared to the prewash samples (median [25th-75th percentile]): squamous cell concentration (0.0 [0.0-0.1 counts/high-powered field (HPF)] vs. 8.3 counts/HPF [4. 0-10.5 counts/HPF], P < 0.05); bacterial contamination (0.1 [0.0-0. 2] vs. 3.0 [0.6-7.7] colony-forming units (CFU)/ml, P < 0.01); and lamellar body concentration (0.0 [0.0-1.0] vs. 22.0 [18.5-29.5] thousands/microl, P < 0.01). No significant differences existed between the postfiltration and maternal samples for each of these parameters. Fetal hemoglobin was in higher concentrations in the postfiltration sample when compared with maternal blood (1.9 [1.1-2. 5] vs. 0.5% [0.3-0.7] ). Potassium levels were significantly less in the postfiltration sample when compared with maternal (1.4 [1.0-1.5] vs. 3.8 mEq/l [3.7-4.0]). CONCLUSIONS: Leukocyte depletion filtering of cell-salvaged blood obtained from cesarean section significantly reduces particulate contaminants to a concentration equivalent to maternal venous blood.
Existing cell salvage systems differ in their ability to clear contaminants and all require the addition of a leukocyte depletion filter.
Cell salvage in obstetrics.
Allam J, Cox M, Yentis SM.
Magill Department of Anaesthesia, Intensive Care and Pain Management, Chelsea and Westminster Hospital, London, UK. email@example.com
The safety of cell salvage in obstetrics has been questioned because of the presumed risk of precipitating amniotic fluid embolism and, to a lesser extent, maternal alloimmunisation. For these reasons, experience in this field is limited and has lagged far behind that in other surgical specialties. There has, however, been renewed interest in its use over recent years, mainly as a result of problems associated with allogeneic blood transfusion. Our aim was to review the medical literature to ascertain the principles of cell salvage, the ability of the process to remove contaminants, and its safety profile in the obstetric setting. The search engines PubMed and Google Scholar were used and relevant articles and websites hand searched for further references. Existing cell salvage systems differ in their ability to clear contaminants and all require the addition of a leukocyte depletion filter. Although large prospective trials of cell salvage with autotransfusion in obstetrics are lacking, to date, no single serious complication leading to poor maternal outcome has been directly attributed to its use. Cell salvage in obstetrics has been endorsed by several bodies based on current evidence. Current evidence supports the use of cell salvage in obstetrics, which is likely to become increasingly commonplace, but more data are required concerning its clinical use.