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Risk of Epidural Hematoma After Neuraxial Techniques in Thrombocytopenic Parturients: A Report From the Multicenter Perioperative Outcomes Group

Lee, L.O.; Bateman, B.T.; Kheterpal, S.; Klumpner, T.T.; Housey, M.; Aziz, M.F.; Hand, K.W.; MacEachern, M.; Goodier, C.G.; Bernstein, J.; Bauer, M.E.Multicenter Perioperative Outcomes Group Investigators

Obstetric Anesthesia Digest: March 2018 - Volume 38 - Issue 1 - p 2–3
doi: 10.1097/01.aoa.0000529963.55974.a2
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(Anesthesiology. 2017;126(6):1053–1063)

Thrombocytopenia is a relative or even absolute contraindication to neuraxial techniques for labor analgesia and cesarean delivery due to a potential increased risk of epidural hematoma, which can cause permanent neurological injury. Consensus on an acceptable platelet count needed for safe execution of neuraxial techniques and risk stratification of this complication by platelet count are unclear. This retrospective cohort study aimed at using the Multicenter Perioperative Outcomes Group (MPOG) database to define the risk of epidural hematoma requiring surgical decompression stratified by platelet count after neuraxial techniques in thrombocytopenic parturients. A systematic review was also done to combine the resulting data with existing literature reporting neuraxial techniques in thrombocytopenic pregnant women.

Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI

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