Document Detail

Retrospective audit of outcome of regional anesthesia for delivery in women with thrombocytopenia.
MedLine Citation:
PMID:  18331206     Owner:  NLM     Status:  MEDLINE    
Regional anesthesia for pain at delivery in the presence of maternal thrombocytopenia is a clinical dilemma. We reviewed 10,369 obstetric cases (12 months) from our tertiary center. Generally, hemodilution of pregnancy does not result in thrombocyte counts of <150,000/mm(3) at delivery. A total of 166 births (1.6%) were recorded in women with thrombocytes <150,000/mm(3) at delivery. Parturients with >150,000/mm(3) at week 36 were separated post hoc (n=35; 21%) and the remaining parturients were divided as having <100,000/mm(3) (n=30; 18%) or 101,000-150,000/mm(3) (n=101; 60.5%). Epidural or spinal anesthesia was administered to 30% women with <100,000/mm(3) whereas 56% women with >101,000/mm(3) received these options (P=0.003). A total of 13.9% of parturients with trimester-long thrombocytopenia required blood products; 10/23 (43.5%) parturients undergoing cesarean section also required blood products (P=0.000). Four of six babies with Apgar scores of <or=7 at 1-min were born to women with platelets <100,000/mm(3) (P=0.009). There were no statistically significant differences in mean birth weights. Women with thrombocytes <150,000/mm(3) at birth but within the normal range at week 36 were more likely multiparas (P=0.001). We conclude that a difference in maternal and neonatal outcomes exists between mothers who were thrombocytopenic only at delivery compared to those with trimester-long thrombocytopenia, with the latter mothers and babies having more adverse events.
Kyra Bernstein; Abigail Baer; Martine Pollack; Dov Sebrow; Deborah Elstein; Alexander Ioscovich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  36     ISSN:  0300-5577     ISO Abbreviation:  J Perinat Med     Publication Date:  2008  
Date Detail:
Created Date:  2008-03-11     Completed Date:  2008-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  120-3     Citation Subset:  IM    
Gaucher Clinic, Shaare Zedek Medical Center, Jerusalem, Israel.
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MeSH Terms
Anesthesia, Obstetrical / adverse effects*
Labor, Obstetric
Medical Audit
Pregnancy Complications, Hematologic*
Pregnancy Outcome*
Retrospective Studies
Thrombocytopenia / complications*

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