title: Platelet counts and coagulation tests prior to neuraxial anesthesia in patients with preeclampsia: a retrospective analysis.
abstract: This retrospective, descriptive study aimed to assess hematologic testing practices in 100 patients with preeclampsia undergoing neuraxial blockade (NB). Prior to NB, platelet (PLT) count was performed in 61 (98%) of 62 women in labor and in 37 (97%) of 38 women undergoing cesarean delivery (CD). No patients had a pre-NB PLT count <70 × 10(9)/L. Pre-NB tests for prothrombin time (PT) and activated partial thromboplastin time (APTT) were less common and varied among laboring patients (15 [24%] of 62) and patients prior to CD (18 [47%] of 38). Prior to NB, PT and APTT values were within normal limits in all patients. The time intervals between laboratory testing and NB ranged from <2 to >12 hours. The lack of consistency in pre-NB coagulation testing and the variable time intervals between laboratory tests and NB may be due to a lack of consensus among anesthesiologists for determining "safe" hemostatic conditions for NB placement in patients with preeclampsia.
authors.affiliation: 1Department of Anaesthesia, University College London Hospital, London, England.
authors.forename: Pervez
authors.initials: P
authors.lastname: Sultan
authors.forename: Alexander
authors.initials: A
authors.lastname: Butwick
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests / Q000379:methods*; D005260:Female; D006801:Humans; D010976:Platelet Count / Q000379:methods*; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000097:blood*