Can cell salvage be used on an OB service? How popular is this practice and are there any medicolegal issues.
I am a strong advocate of salvage in obstetrical hemorrhage. There are many hospitals in the US that use blood salvage in hemorrhage. At Magee Women's Hospital, we have used it over 100 times in hemorrhaging women. The National Health Services in Britain has a policy statement that blood salvage should be the preferred option for provision of blood during an obstetrical hemorrhage. So, you have an entire country that advocates it.
As to liability, the lawyers can sue you for anything. In fact, if a patient developed a complication from an allogeneic blood product, you could be held liable in a court of law for not using blood salvage because it's a published alternative that has no reported complications in obstetrics, only theoretical complications; whereas, allogeneic has lots of reported complications, not theoretical.
Blood salvage is an off-label indication in obstetrics but most of medical practice is off-label because it's very, very expensive to get a labeling indication from the FDA. Most of the anesthetic drugs that I use in obstetrics are off-label.
Jonathan H. Waters, MD