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| Hemostatic effects of dilute and recovered autologous blood transfusions during a cesarean section in placenta previa and their effects on maternal and infant outcomes |
| NIE Xin1 DING Jie1 SUN Caifeng2▲ |
1.Department of Anesthesiology, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Changzhou 213000, China;
2.Department of Obstetrics and Gynecology, Changzhou Maternal and Child Health Care Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Changzhou 213000, China |
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Abstract Objective To investigate the effect of dilute and recovered autologous blood transfusions during a cesarean section in placenta previa and their effects on maternal and infant outcomes. Methods From January 2017 to February 2020, 80 puerpera with dangerous placenta previa who underwent cesarean section in Department of Obstetrics and Gynecology of Changzhou Maternity and Child Health Hospital of Nanjing Medical University were selected. According to different methods of autologous blood transfusion, they were divided into dilution group (diluted autologous blood transfusion) and recovered group (recovered autologous blood transfusion). Maternal peripheral venous blood before the blood collection (T1), blood collection (T2), immediately after the closing abdomen (T3) and 24 h after surgery (T4) four times respectively were collected, and hemoglobin (Hb) of maternal was detected using automatic blood cell analyzer, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (Fg) were detected by solidification method. The hemostatic effect, maternal and infant outcome and complication rate of two groups were compared. Results There were no significant differences in blood separation and intraoperative blood loss between two groups (P ＞ 0.05). The overall analysis showed that there were no significant differences in PT and Fg between two groups in terms of time, inter group and interaction (P > 0.05). There were significant differences in APTT and Hb between two groups in terms of time (P < 0.05), but there were no significant differences in APTT and Hb between two groups in inter group and interaction (P > 0.05). Further pairwise comparison, intra group comparison: APTT in two groups was T3, T4, T2, T1 from long to short (P < 0.05), and Hb from high to low was T1, T2, T3, T4 (P < 0.05). Comparison between groups: there were no significant differences in PT, APTT, Fg and Hb between two groups (P > 0.05). There were no significant differences in one-minute Apgar score, five-minute Apgar score and umbilical artery blood pH between two groups (P > 0.05). The incidence of transfusion complications in recovered group was lower than that in diluted group (P < 0.05). Conclusion Dilute and recovered autologous blood transfusions have no significant difference in hemostatic effects and effects on infant outcomes during the risk of cesarean section in puerpera with dangerous placenta previa, but recovered autologous blood transfusions have fewer complications and higher safety.
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