THE USE OF ACUTE HEMODILUTION IN PARTURIENTS UNDERGOING CESAREAN-SECTION

OBJECTIVE: Concern over transmissible disease has increased interest i n methods of minimizing homologous blood transfusion during elective s urgery. One method is acute hemodilution, a technique previously unrep orted in parturients. This study was designed to determine its feasibi lity and safety in women at risk of hemorrhage during cesarean section . STUDY DESIGN: This technique was performed on 38 parturients. Collec ted blood was retransfused at the end of surgery or earlier, if requir ed. Hemoglobin was measured before hemodilution, after hemodilution, b efore transfusion, after transfusion, and 24 hours postoperatively. Ne onatal assessment included umbilical blood gases and Apgar scores. RES ULTS: All patients were hemodynamically stable and no fetal heart rate abnormalities were observed during the procedure. One patient receive d homologous blood and 14 received previously donated autologous blood . Umbilical blood gases were normal and 5-minute Apgar scores were gre ater than or equal to 7. CONCLUSION: This study suggests that acute he modilution is well tolerated in parturients undergoing cesarean sectio n. This may limit exposure to homologous blood transfusion.