title: Anesthetic practices for patients with preeclampsia or HELLP syndrome: A survey.
abstract: OBJECTIVE
  Substantial controversy exists regarding anesthetic management for patients with preeclampsia or hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome. Experts, researchers, clinicians, and residents in Turkey were surveyed about their practices.
  
  
  METHODS
  Questionnaires were distributed to attendees at a national conference, and they were filled out immediately. Anonymous 10-item paper surveys were administered to both residents and non-residents. Descriptive statistics were used in the analysis. Agreement among ≥75% of the respondents was considered a majority opinion. Surveys with missing responses were used to analyze the non-response bias. The Chi-square test was used for comparisons. A historical cohort of obstetricians-gynecologists was used for comparison with anesthesiologists.
  
  
  RESULTS
  Of 339 surveys distributed, 288 were returned (84.9% response rate). Among the returned surveys, the completion rate was 96.1%. The job experience in years among clinicians and residents was 9±5 and 3±1, respectively. General anesthesia was still significantly preferred by 36.1% among patients with preeclampsia with platelet counts of ≥100,000/μL. Compared to obstetricians-gynecologists, anesthesiologists more often preferred general anesthesia. With platelet counts of <50,000/μL or eclampsia, most respondents preferred general anesthesia 94.4% for very low platelets and 89.5% for eclampsia.
  
  
  CONCLUSIONS
  A preferential trend toward general anesthesia for patients with preeclampsia or HELLP syndrome exists among anesthesiologists in Turkey, particularly for patients with severe thrombocytopenia and/or eclampsia. There exists a need for well-designed and well-executed prospective clinical trials to provide evidence for the best consensus practice.
authors.affiliation: Department of Anesthesiology, Konya Training and Research Hospital, Konya, Turkey.
authors.forename: Betül
authors.initials: B
authors.lastname: Başaran
authors.affiliation: Department of Anesthesiology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Bilge
authors.initials: B
authors.lastname: Çelebioğlu
authors.affiliation: Department of Obstetrics and Gynecology, Konya Training and Research Hospital, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Başaran
authors.affiliation: Department of Anesthesiology, Ankara Gazi Mustafa Kemal State Hospital, Ankara, Turkey.
authors.forename: Seher
authors.initials: S
authors.lastname: Altınel
authors.affiliation: Department of Anesthesiology, Konya Training and Research Hospital, Konya, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Kutlucan
authors.affiliation: Department of Obstetrics and Gynecology, The University of Mississippi Medical Center, Jackson, USA.
authors.forename: James N
authors.initials: JN
authors.lastname: Martin
keywords: Anesthesia; HELLP syndrome; glucocorticoids; platelet count; preeclampsia; survey