Conclusion
Placenta accreta spectrum, uterine fibroids, and revision surgery in
patients with postoperative bleeding appear to predict autotransfusion
with ICS during cesarean section. In these contexts, as in situations
where transfusion difficulties are expected, the use of ICS should be
anticipated to reduce the need for homologous transfusion in these young
women. In case of rhesus incompatibility, it should be performed along
with the preventive injection of Rh immune globulin.
Although severe PPH occurs frequently during cesarean section, most
instances occur during vaginal delivery. The use of ICS during cesarean
section is widespread, but its use for vaginal delivery is still under
consideration because of concerns about infection and feasibility. In
the future, salvage of vaginal bleeding with autotransfusion may lead to
real changes in the management of PPH and accelerate the inclusion of
ICS devices in the maternity ward.