A 33-year-old G2P1 with placenta previa at 37 weeks is posted for elective cesarean section. Preoperative hemoglobin is 9.5 g/dL. The anesthesiologist requests cell saver (autologous blood transfusion) availability. The most important contraindication to cell saver in obstetrics is:
- A Risk of amniotic fluid embolism ✓
- B Risk of hemolysis
- C Risk of air embolism
- D Risk of HIV transmission
Correct answer: A. Risk of amniotic fluid embolism
Explanation
The theoretical concern with cell saver in cesarean is reintroducing amniotic fluid and fetal squames, causing amniotic fluid embolism. Modern leukocyte depletion filters have made this risk negligible, but it remains the classic stated contraindication. Hemolysis and air embolism are general risks, not obstetric-specific.
Reference: Chestnut's Obstetric Anesthesia, 6th ed.
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