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Neuraxial Anesthesia in Parturients With Thrombocytopenia: A Multisite Retrospective Cohort Study

Goodier, C.G.; Lu, J.T.; Hebbar, L.; Segal, B.S.; Goetzl, L.

Obstetric Anesthesia Digest: June 2016 - Volume 36 - Issue 2 - p 57–58
doi: 10.1097/01.aoa.0000482588.42640.36
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Commentary

(Anesth Analg. 2015;121:988–991)

Thrombocytopenia, defined as a platelet count <100,000/mm3 in this study, is a relative contraindication to neuraxial analgesia because of the unknown risk of hematoma. Although the risk of hematoma might outweigh the benefits of neuraxial anesthesia, withholding neuraxial anesthesia may result in suboptimal pain management and increased risk of general anesthesia-associated maternal morbidity. Consequently, the authors of the present study evaluated risk estimates of spinal-epidural hematoma after neuraxial anesthesia and of general anesthesia-associated complications in thrombocytopenic parturients. The primary goal was to determine a precise platelet threshold for withholding neuraxial anesthesia in thrombocytopenic parturients.

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Medical University of South Carolina, Charleston, SC

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