Retrospective audit of outcome of regional anesthesia for delivery in women with thrombocytopenia
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Kyra Bernstein
Abstract
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 tertiery center. Generally, hemodilution of pregnancy does not result in thrombocyte counts of <150,000/mm3 at delivery. A total of 166 births (1.6%) were recorded in women with thrombocytes <150,000/mm3 at delivery. Parturients with >150,000/mm3 at week 36 were separated post hoc (n=35; 21%) and the remaining parturients were divided as having <100,000/mm3 (n=30; 18%) or 101,000–150,000/mm3 (n=101; 60.5%). Epidural or spinal anesthesia was administered to 30% women with <100,000/mm3 whereas 56% women with >101,000/mm3 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 ≤7 at 1-min were born to women with platelets <100,000/mm3 (P=0.009). There were no statistically significant differences in mean birth weights. Women with thrombocytes <150,000/mm3 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.
©2008 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Prenatal long-chain polyunsaturated fatty acid status: the importance of a balanced intake of docosahexaenoic acid and arachidonic acid
- Population-based standardization (PBS) of institutional cesarean delivery rates
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- Retrospective audit of outcome of regional anesthesia for delivery in women with thrombocytopenia
- The association between maternal characteristics and different types and levels of discordance in triplet pregnancies
- Obstetric gel shortens second stage of labor and prevents perineal trauma in nulliparous women: a randomized controlled trial on labor facilitation
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- Nuchal cord in post-term pregnancy – relationship to suspected intrapartum fetal distress indicating operative intervention
- Risk assessment of trisomy 21 by maternal age and fetal nuchal translucency thickness in 7096 unselected pregnancies in Slovenia
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- 17-Hydroxyprogesterone in premature infants as a marker of intrauterine stress
- Prenatal hypoxia preconditioning improves hypoxic ventilatory response and reduces mortality in neonatal rats
- Mortality and morbidity of neonates born at <26 weeks of gestation (1998–2003). A population-based study
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- Computerized FHR traces in post-term pregnancies
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