Cell salvage

2 options for autologous transfusion

1.Chronic Isovolaemic haemodilution
Preop blood conservation

2.redcell salvage-fresh oxygenated cells

Why centrifuge blood after collection?
Red cells heavier but heparin isn't
No need for storage

How to collect blood?
*Suck from pool of blood /low pressure suction is preferrable
*No compatibility testing is necessary
*Clean operative field



Obstetrics cell salvage
1-AFE risk
2-Rh incompatiblity-fetal redcells



Cell salvage in malignancy-risk of retransfusion of malignant cells.

NICE guideline intraoperative cell salvage in Obstetrics
Incident reporting
Placenta previa/accreta
Poor quality trials
Leucocyte filters doesn't remove all the fetal squames but is this is not important as fetal sqaumes aren't implicated in amniotic fluid embolism

Rh mismatch-Kleinaugher/Anti-D


Leucocyte depletion filter is negatively charged.It
also take out fetal squames&Bacteria


Amniotic fluid components-soluble components removed by washing

-solid components by filter


Logistics
1-when to iniate salvage-whether to leave the liquor out
2-Lecocyte filter associated hypotension
3-volume of washing-how much
4-leucocyte filter takes time


Malignant cells in vitro tests to detect malignant cells & viability in collected blood

Leucocyte filter-450 ml capacity/slow delivery/can become saturated/needs
Experienced staff


www.transfusionguideline.org.uk

care plan for women refusing blood transfusion in labour

British Committee for Standards in Haematology (BCSH)-Blood transfusion guidelines

Podcasts on obsterics & gynaecology

Podcasts from University of California, San Francisco School of Medicine

1. OBGYN: Women's Medicine
2. OBGYN: High Risk Pregnancies
3. OBGYN: Issues in Women's Health

Crisis OB Video Series - Part II: Hemorrhage




Medicine audio news

What I learned this week?

Simple rules to distinguish between malignant and benign adnexal masses

Five simple rules to predict malignancy(M-rules)

1-irregular solid tumour

2-ascites

3-at least 4 papillary processes

4-irregular mutilocular solid tumour with a largest daimeter of atleast 100mm

5-very high color score using color Doppler

Five simple rules to suggest benign tumor(B-rules)

1-unilocular cyst

2-presence of solid components where the largest solid component is <7mm in largest diameter.

3-acoustic shadows

4-smooth mutilocular tumor less than 100mm in largest diameter

5-no detectable blood flow at doppler examination

from:International Ovarian Tumor Analysis study group

Mnemonics for Medical Undergraduates

What is BOLD MRI?

BOLD stands for blood oxygen level -dependent effect in MRI.It is based on the fact ,that the magnetic properties at haemoglobin vary depending on its oxygenation .It is realiable non-invasive method for measuring changes in tissue oxygenation in the fetus.*

PAPP-A

pregnancy-associated plasma protein (PAPP-A) are associated to both increased risk of aneuploides and impaired trophoblast.

First trimester screening markers-These are altered in pregnancies conceived after IVF/ICSI(ovarian stimulation)*

Primary CMVinfection with normal U/S and MRI follow up have favorable outcome for the infant.If the U/S followup alone is considered normal the riks for sequlae is minimal.*

RSS feeds from OBGYN net

What are they talking about obstetrics in Twitter?

What are they talking about gynaecology in Twitter?

50 video clips on pregnancy

Latest news from Reproductive health

Books for MRCOG