Comparison of Different Blood Transfusion Methods in Patients Undergoing Cesarean Section

Abstract

PurposeTo compare the effect of allogeneic transfusion and acute normovolemic hemodilution (ANH) autologous transfusion in patients undergoing cesarean section.MethodsPatients who underwent cesarean section and received blood transfusion therapy from February 2019 to July 2021 in our hospital were observed and divided into the allogeneic group (n = 55) who received allogeneic transfusion therapy and the autologous group (n = 55) who received ANH autologous transfusion therapy according to the mode of transfusion. Observations included vital signs [heart rate (HR), mean arterial pressure (MAP), stroke volume variation (SVV)], blood routine [red blood cells (RBC), platelets (PLT), hematocrit (HCT), hemoglobin (Hb)], T-cell subsets (CD4+, CD8+, CD4+/CD8+), immunoglobulins (IgA, IgM, IgG), inflammatory factors [C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6], and adverse effects were counted in both groups.ResultsThere was no statistical significance in the intra-group and inter-group comparisons of HR, MAP, and SVV between the two groups before transfusion and transfusion for 10 min (P > 0.05). 5d after operation, the RBC, PLT, HCT, and Hb of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). 5d after operation, the CRP, TNF-α, and IL-6 of the allogeneic group were higher than those before operation, and the autologous group was lower than that of the allogeneic group (P < 0.05). 5d after operation, the CD4+, CD4+/CD8+ of the allogeneic group were lower than before operation, and the CD8+ was higher than before operation. The CD4+ and CD4+/CD8+ of the autologous group were higher than that of the allogeneic group, and CD8+ was lower than that of the allogeneic group (P < 0.05). 5d after operation, the IgA, IgG, and IgM of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). During blood transfusion, there was no significant difference in the adverse reaction rate between the two groups (P > 0.05).ConclusionBoth allogeneic transfusion and ANH autologous transfusion have little effect on the vital signs of patients undergoing cesarean section, but ANH autologous transfusion is more helpful to the stability of blood routine, T-cell subsets, immunoglobulin, and inflammation levels after surgery, which is a safe and effective way of blood transfusion.

Effect of intraoperative blood transfusion during maternal cesarean section on serum electrolytes and inflammatory response plus cellular immune response: A retrospective study

“…They concluded that the reduction of fluctuations in vital signs depended on the reduction of pro-inflammatory factors and the stability of hemodynamics. Guo F et al [26] also found that CRP, TNF-α and IL-6 in the blood of puerperae in the autotransfusion group were higher than those before the transfusion, but still significantly lower than those in the control group, suggesting that allogeneic blood transfusion inevitably involves even minor immune rejection, allowing inflammatory cells to infiltrate the vessel wall, and that the release of inflammatory factors affects the patient hemodynamic stability, thus exacerbating the inflammatory response. We know that surgery can lead to a stress response in the body that activates the release of inflammatory factors, and the immune capacity of the puerpera is suppressed after surgery.…”

“…The results of this study showed that CD3+, CD4+ levels and CD4+/CD8+ ratios were lower in the 2 groups of puerperae on the first postoperative day compared to those before the surgery, suggesting a decrease in the puerperae’ cellular immune function; The reason for this may be related to the absence of immunoneutral effectors in autologous blood. [26,32,33]…”

“…The results of this study showed that CD3+, CD4+ levels and CD4+/CD8+ ratios were lower in the 2 groups of puerperae on the first postoperative day compared to those before the surgery, suggesting a decrease in the puerperae' cellular immune function; The reason for this may be related to the absence of immunoneutral effectors in autologous blood. [26,32,33] There are limitations to this study. The small sample size of the subjects included in this study resulted in the benefits of autotransfusion possibly not being fully realized.…”

Effect of intraoperative cell salvage on coagulation function outcomes in patients with massive post-Cesarean section hemorrhage

“…Inclusion criteria: (1) women of childbearing age who underwent elective cesarean section at Suqian Maternity and Children's Hospital of Jiangsu Province, with expected postpartum hemorrhage exceeding 1000 mL or blood loss exceeding 20% of systemic blood volume, accompanied by symptoms or signs of reduced blood volume [11]; (2) aged 26~41 years old. Exclusion criteria: (1) emergency cesarean section; (2) patients who were unconscious or unable to cooperate effectively; (3) patients with severe medical or surgical conditions; (4) anemia or abnormal coagulation function; (5) participation in other intervention studies; (6) allergic to blood products; (7) mental disorders; (8) patients who were transferred to cesarean section after failed vaginal trial of labor; (9) intraoperative assessment determining no need for blood transfusion.…”

“…It serves as an effective first-aid measure for patients experiencing massive bleeding during surgery [6,7]. Studies have shown that compared to ABT, the use of ICS during surgery not only reduces the need for integrated blood products but also buys critical time for effective patient rescue, thereby improving the success rate of resuscitation [8,9]. Moreover, autologous blood transfusion from ICS is relatively fresh, exhibiting superior coagulation function and oxygen-carrying capacity compared to stored allogeneic blood.…”