Bibliographic information
GuidelineConsolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage
Year of Publication2025
Issuing InstitutionWorld Health Organization
Recommendation
New
Cell salvage is recommended for the treatment of postpartum haemorrhage only in the context of rigorous research
Notes and Remarks
- The GDG acknowledged the potential of cell salvage in the treatment of PPH among women having caesarean births but considered the evidence on desirable effects insufficient to make a recommendation for routine clinical practice.
- The group agreed that rigorous research studies comparing cell salvage with no cell salvage, especially in women who are at high risk of PPH and likely to need blood transfusion intraoperatively, are needed. The aim of such studies would be to demonstrate the impact of cell salvage on blood transfusion related to PPH, in addition to improvements on other important outcomes, such as improved well-being and satisfaction. Given the challenges with designing large high-quality randomized trials on this topic, the GDG highlighted the added value of high-quality controlled non-randomized studies, especially those investigating the adverse effects of the intervention.
- To date, studies have used broad criteria for classifying women at risk of PPH, but it was unclear if these women were also at a higher risk for requiring a blood transfusion. If lower-risk women were included, this may have contributed to the results showing lack of efficacy of treatment with cell salvage. Additional research focusing on women at high risk for requiring blood transfusion (e.g. women with placenta accreta) is particularly needed.
- When cell salvage is used in a research context, it is important to monitor for adverse events from autotransfusion and evidence of fetomaternal haemorrhage to adjust the need for anti-D prophylaxis