Coagulation studies in the preeclamptic parturient: a survey.
OBJECTIVE
To delineate current practice with regard to how coagulation status is evaluated before induction of regional anesthesia in the preeclamptic parturient, with the goal of defining appropriate testing.


METHODS
A confidential survey was mailed to the chairmen of all 113 anesthesiology residency training programs in the United States listed in the American Medical Association's American Medical Graduation Education guide, to be passed on to the director of obstetric anesthesia.


METHODS
Academic institutions providing obstetric anesthesia services in the United States.


METHODS
Following the original study, there was no additional follow-up or intervention.


RESULTS
The 21-question survey explored institutional characteristics such as the number of deliveries, the use of regional anesthesia, and the laboratory tests required prior to placement of a regional anesthetic in the mildly or severely preeclamptic parturient under two degrees of operative urgency. In the 74 programs entered into the analysis, we found that regional anesthesia was used in the majority of cesarean sections and more than half of the vaginal deliveries. In an urgent situation, most of the programs required no test of coagulation status in the mild preeclamptic parturient and only a platelet count in the severe preeclamptic parturient.


CONCLUSIONS
In the majority of academic programs in the United States, we found that the evaluation of coagulation status in the preeclamptic parturient was based primarily on a platelet count. A review of the literature supports this pattern of testing.
Voulgaropoulos
D S
DS
Department of Anesthesiology, Arizona Health Sciences Center, University of Arizona, Tucson 85724.
Palmer
C M
CM
D000765:Anesthesia, Conduction; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D000776:Anesthesiology / Q000193:education; D001778:Blood Coagulation Disorders / Q000150:complications / Q000175:diagnosis*; D001780:Blood Coagulation Tests; D002585:Cesarean Section; D036861:Delivery, Obstetric; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000097:blood* / Q000150:complications; D011247:Pregnancy; D011517:Prothrombin Time