morphine and Fetomaternal-Transfusion

Haemorrhage remains an important cause of maternal mortality worldwide. Cell salvage carries a theoretical risk of amniotic fluid embolus syndrome and is too expensive for use in many parts of the world. To explore cheaper options, we investigated whether a leucocyte depletion filter alone removes components of pure amniotic fluid. Amniotic fluid was collected from 10 women during elective caesarean section and passed through a LeukoGuard® RS filter. Pre- and post-filtration samples were compared in the laboratory. Lamellar bodies and fetal squames were almost completely removed (filtration efficacy 96.6% and 99.9%, respectively; p<0.0001 and <0.0004), and hair was completely removed (p=0.002). Filtration had no effect on concentrations of α-fetoprotein, tissue factor or endothelin-1, or on the presence of meconium or vernix. Additional work is required to evaluate whether cell salvage using filtration alone may be useful in maternal haemorrhage in the developing world.

Topics: Adult; alpha-Fetoproteins; Amniotic Fluid; Cesarean Section; Cytological Techniques; Developing Countries; Endothelin-1; Female; Fetomaternal Transfusion; Filtration; Hair; Humans; Infant, Newborn; Leukocytes; Meconium; Monitoring, Intraoperative; Operative Blood Salvage; Pregnancy; Thromboplastin; Vernix Caseosa

Topics: ABO Blood-Group System; Female; Fetal Hemoglobin; Fetomaternal Transfusion; Humans; Infant, Newborn; Infant, Premature; Meconium; Obstetric Labor Complications; Parity; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Rh-Hr Blood-Group System; Twins

Topics: Asphyxia; Blood Transfusion; Color; Cyanosis; Female; Fetofetal Transfusion; Fetomaternal Transfusion; Gestational Age; Heart Defects, Congenital; Hematocrit; Hemorrhage; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lung Diseases; Meconium; Oxygen Inhalation Therapy; Placenta Diseases; Positive-Pressure Respiration; Pregnancy; Resuscitation; Skin Manifestations