Thrombocytopenia and platelet functional defects in pre-eclampsia: implications for regional anaesthesia.
A prospective, observational study of forty pre-eclamptic patients was conducted to confirm or refute reports of a platelet functional defect superimposed on the consumptive thrombocytopenia of pre-eclampsia. Investigations included a platelet count, in vivo platelet function as assessed by a Duke bleeding time, and in vitro platelet function as assessed by thromboxane B2 and Platelet Factor 3 (PF 3). The overall incidence of thrombocytopenia was 15%. Prolonged bleeding time and slightly decreased availability of PF 3 (evidence of possible platelet dysfunction) was present in 2.5% of patients while 21% had evidence of fibrinolysis with an elevated monoclonal D-dimer. In the assessment of suitability for regional blockade, a platelet count is essential. If the platelet count is between 50 and 100 x 10(9)/l a bleeding time is indicated.
Schindler
M
M
Department of Anaesthesia, Royal Hospital for Women, Paddington, Sydney, New South Wales.
Gatt
S
S
Isert
P
P
Morgans
D
D
Cheung
A
A
D000765:Anesthesia, Conduction; D000773:Anesthesia, Obstetrical; D001780:Blood Coagulation Tests; D001792:Blood Platelets / Q000502:physiology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015994:Incidence; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000097:blood* / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood
D005338:Fibrin Fibrinogen Degradation Products; D006454:Hemoglobins; D014527:Uric Acid