1
|
Intra-operative cell salvage for cesarean delivery: a retrospective study using propensity score matched analysis. Chin Med J (Engl) 2020; 133:183-189. [PMID: 31929368 PMCID: PMC7028168 DOI: 10.1097/cm9.0000000000000620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obstetric hemorrhage is a major cause of maternal death during cesarean delivery. The objective of this retrospective observational study was to evaluate the efficacy and safety of intra-operative cell salvage (IOCS) in cesarean section. METHODS We included a total of 361 patients diagnosed with central placenta previa who underwent cesarean section from May 2016 to December 2018. In this study, 196 patients received autologous transfusion using IOCS (IOCS group) and 165 patients accepted allogeneic blood transfusion (ABT group). Propensity score matched analysis was performed to balance differences in the baseline variables between the IOCS group and ABT group. Patients in the IOCS group were matched 1:1 to patients in the ABT group. RESULTS After propensity score matching, 137 pairs of cases between the two groups were successfully matched and no significant differences in baseline characteristics were found between the IOCS group and ABT group. Patients in the IOCS group were associated with significantly shorter length of hospital stay, compared with ABT group (8.9 ± 4.1 days vs. 10.3 ± 5.2 days, t = -2.506, P = 0.013). The postoperative length of hospital stay was 5.3 ± 1.4 days for patients in the IOCS group and 6.6 ± 3.6 days for those in the ABT group (t = -4.056, P < 0.001). The post-operative hemoglobin level in the IOCS group and ABT group was 101.3 ± 15.4 and 96.3 ± 16.6 g/L, respectively, which were significantly different (t = 2.615, P = 0.009). Allogeneic red blood cell transfusion was significantly lower at 0 unit (range: 0-11.5 units) in the IOCS group when compared with 2 units (range: 1-20 units) in the ABT group (P < 0.001). CONCLUSIONS This retrospective observational study using propensity score matched analysis suggested that IOCS was associated with shorter length of postoperative hospital stay and higher post-operative hemoglobin levels during cesarean delivery.
Collapse
|
2
|
Iwasaki S, Hamada K, Takahashi K, Takahashi M, Mizuno E, Mizukami N, Yamakage M. Epidural analgesia for the treatment of colic attack with retrocaval ureter in late pregnancy complicated with marginal placenta previa: a case report. JA Clin Rep 2019; 5:52. [PMID: 32026019 PMCID: PMC6966975 DOI: 10.1186/s40981-019-0271-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background Retrocaval ureter was diagnosed in a woman complaining of ureteric pain in the last trimester of pregnancy. We describe the rationale behind the administration of epidural analgesia for her colic attack. Case presentation A 41-year-old pregnant woman was hospitalized with a diagnosis of a marginal placenta previa at 34 weeks and 5 days of pregnancy. Her right ureter encircled the dorsal aspect of the inferior vena cava (IVC) and was compressed by a growing fetus, causing hydronephrosis. Her right lower back pain was exacerbated every day, till an epidural catheter was inserted. Her estimated glomerular filtration rate (eGFR) and hematocrit worsened, and an elective cesarean section was performed. Conclusion Epidural analgesia only provided pain relief for a few days. When a pregnant woman presents with a retrocaval ureter and severe pain, short-term epidural analgesia should be considered after evaluating the complex medical condition and size of the fetus.
Collapse
Affiliation(s)
- Soshi Iwasaki
- Department of Anesthesiology, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan. .,Ain Holdings and Nitori Holdings Department of Palliative Medicine, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan.
| | - Kohsuke Hamada
- Department of Anesthesiology, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan
| | - Kazunobu Takahashi
- Department of Anesthesiology, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan
| | - Mika Takahashi
- Department of Anesthesiology, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan
| | - Eri Mizuno
- Department of Anesthesiology, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan
| | - Naomi Mizukami
- Department of Anesthesiology, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan.,Ain Holdings and Nitori Holdings Department of Palliative Medicine, Sapporo Medical University, South1, West16, Chuo-ku, Sapporo City, Hokkaido, Japan
| |
Collapse
|