Why the study?
What are the hematologic testing practices prior to neuraxial anesthesia in patients with preeclampsia?
What are the hematologic testing practices prior to neuraxial anesthesia in patients with preeclampsia?
There is significant variability in pre-neuraxial blockade coagulation testing practices and timing among patients with preeclampsia, highlighting a lack of consensus.
Variable pre-neuraxial testing in preeclampsia should not yet change practice; leaves open standardized protocols and prospective safety studies.
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.
No takes yet. Share an insight, caveat, or question.
Sultan et al. (2012) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: