Why the study?
Does clopidogrel use during cesarean delivery increase the risk of perioperative bleeding in a patient with a drug-eluting coronary stent?
Does clopidogrel use during cesarean delivery increase the risk of perioperative bleeding in a patient with a drug-eluting coronary stent?
Clopidogrel use during cesarean delivery is associated with an elevated risk of perioperative bleeding, suggesting discontinuation 5 or more days prior to surgery when feasible.
May indicate perioperative bleeding risk with clopidogrel at cesarean; hypothesis-generating for management in stented patients.
BACKGROUND: Little information regarding the potential implications of drug-eluting stents and clopidogrel on pregnancy exists. CASE: We report a case of a 27-year-old woman who received a drug-eluting coronary stent for an acute myocardial infarction and was started on clopidogrel as treatment. She was on clopidogrel when she conceived and delivered a child by cesarean. Her postpartum course was complicated by postoperative bleeding requiring transfusion. CONCLUSION: This case highlights the perinatal and peripartum concerns of these interventions in women of childbearing age. It suggests that cesarean delivery is associated with an elevated risk of perioperative bleeding and may best be approached like other surgical procedures, with the optimal timing of surgery, when feasible, being 5 or more days after the discontinuation of clopidogrel.
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Myers et al. (2011) studied this question.
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