title: Safe epidural analgesia in thirty parturients with platelet counts between 69,000 and 98,000 mm(-3).
abstract: Regional anesthesia is a popular form of pain relief for the management of labor and delivery. Thrombocytopenia is considered a relative contraindication to the administration of regional anesthesia. Some authorities have recommended that an epidural anesthetic be withheld if the platelet count is <100,000 mm(-3). For the period of March 1993 through February 1996, we reviewed the charts of all parturients who had a platelet count <100,000 mm(-3) during the peripartum period. Eighty women met this criterion. Of these 80, 30 had an epidural anesthetic placed when the platelet count was <100,000 mm(-3) (range 69,000-98,000 mm(-3)), 22 had an epidural anesthetic placed with a platelet count >100,000 mm(-3) that subsequently decreased below 100,000 mm(-3), and 28 did not receive a regional anesthetic. We found no documentation of any neurologic complications in the medical records. We conclude that regional anesthesia should not necessarily be withheld when the platelet count is <100,000 mm(-3).
authors.affiliation: Department of Anesthesiology, Mount Sinai School of Medicine, New York, New York, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Beilin
authors.forename: J
authors.initials: J
authors.lastname: Zahn
authors.forename: M
authors.initials: M
authors.lastname: Comerford
mesh_terms: D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local / Q000008:administration & dosage; D001780:Blood Coagulation Tests; D002045:Bupivacaine / Q000008:administration & dosage; D002585:Cesarean Section; D000075202:Contraindications; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D015994:Incidence; D007743:Labor, Obstetric; D008012:Lidocaine / Q000008:administration & dosage; D009422:Nervous System Diseases / Q000209:etiology; D009772:Obstetrical Forceps; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000503:physiopathology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000503:physiopathology*; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000503:physiopathology; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000503:physiopathology*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine