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Implementation and on-going improvement of an obstetric intra-operative cell salvage service

Student thesis: Doctoral Thesis

Obstetric haemorrhage is still a leading cause of mortality and morbidity in what is essentially a young healthy population. Treatment for haemorrhage, outside surgical techniques, was replacement of blood loss with allogeneic (donor) blood. Although blood transfusion is a life-saving treatment, it is a limited resource with shortages, is increasingly expensive and is not without risk. Blood from the UK is one of the safest in the world, but there is still a risk of bacterial and viral transmission, as well asconcerns with the quality. As such, alternatives need to be identified.
One such alternative is the process of intra-operative cell salvage. For many years, and still ongoing to some degree, obstetric cell salvage has been contraindicated, essentially based on two concerns: amniotic fluid embolus and red cellalloimmunisation.
The focus of my research has been the implementation of an intra-operative cell salvage service into our hospital, addressing the concerns and risks with it, and investigating the quality of the cell salvaged blood.
Following the research work undertaken, intra-operative cell salvage is now established in all caesarean sections 24 hours a day, seven days a week within our hospital; very few centres offer this. It is an essential component of our obstetric patient management strategy.
Original languageEnglish
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Supervisors/Advisors
Award dateJan 2019

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