title: Expanding perfusion across disciplines: the use of thrombelastography technology to reduce risk in an obstetrics patient with Gray Platelet Syndrome--a case study.
abstract: It is important that our speciality continues to push its boundaries. Our perfusion team has invested time lecturing to non-cardiac specialties about perfusion-led technology. This resulted in working closely with the obstetrics team to treat a pregnant patient with the bleeding disorder Gray Platelet Syndrome. In the first instance, we used our Thromboelastograph (TEG) platelet mapping programme to assess the patient. These results agreed with the platelet aggregation tests, showing a degree of platelet inhibition, but it was the overall clotting profile (basic thrombelastograph), showing a borderline hyper-coagulable state, that was of most interest and commonly seen in pregnancy. We believe a TEG result within acceptable limits could help re-adjust the risk of spinal haematomas following regional anaesthesia, thereby, reducing the risks of difficult intubation and general anaesthetic exposure to the baby. The case study describes both basic and platelet mapping thrombelastographs and their potential role in not only this patient with Gray Platelet Syndrome, but any obstetric patient where there are bleeding concerns.
authors.affiliation: Department of Clinical Perfusion Science, Essex Cardiothoracic Centre, Basildon & Thurrock University Hospital, Nethermayne, Essex, UK. ann.clements@btuh.nhs.uk
authors.forename: Ann
authors.initials: A
authors.lastname: Clements
authors.forename: Sucheta
authors.initials: S
authors.lastname: Jindal
authors.forename: Chris
authors.initials: C
authors.lastname: Morris
authors.forename: Garima
authors.initials: G
authors.lastname: Srivastava
authors.forename: Amaju
authors.initials: A
authors.lastname: Ikomi
authors.forename: John
authors.initials: J
authors.lastname: Mulholland
mesh_terms: D000328:Adult; D000765:Anesthesia, Conduction; D005260:Female; D055652:Gray Platelet Syndrome / Q000097:blood*; D046748:Hematoma, Epidural, Spinal / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood*; D013916:Thrombelastography