Thromboelastographic Evaluation of Thrombocytopenic Parturients

Campbell, David; Sawatzky, Karen; Yip, Ray

doi:10.1097/00000542-199904001-00012

Cited by 3 publications

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“…Details of the included studies are presented in Table 4. 6,12,13,[19][20][21][22][23][24][25][26][27][28][29] Reported platelet count ranges from several studies did not discretely fall within the platelet count ranges of 50,000 -69,000 mm −3 and 70,000 -100,000 mm −3 used in the analysis of the MPOG cases; these were not included in the risk analysis for these ranges but were included in the overall reported number of neuraxial procedures performed in thrombocytopenic parturients. None of the centers involved in these previous studies contributed data to MPOG, resulting in no patient overlap.…”

Section: Resultsmentioning

confidence: 99%

Risk of Epidural Hematoma After Neuraxial Techniques in Thrombocytopenic Parturients: A Report From the Multicenter Perioperative Outcomes Group

Lee¹,

Bateman²,

Kheterpal³

et al. 2018

Obstetric Anesthesia Digest

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Background-Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma. There is limited literature to estimate the risk of epidural hematoma in thrombocytopenic parturients. The authors reviewed a large perioperative database and performed a systematic review to further define the risk of epidural hematoma requiring surgical decompression in this population.Methods-The authors performed a retrospective cohort study utilizing the Multicenter Perioperative Outcomes Group (MPOG) database to identify thrombocytopenic parturients who received a neuraxial technique and to estimate the risk of epidural hematoma. Patients were stratified by platelet count and those requiring surgical decompression were identified. A systematic review was performed and risk estimates were combined with those from the existing literature.Results-573 parturients with a platelet count <100,000 mm −3 who received a neuraxial technique across 14 institutions were identified in the MPOG database, and a total of 1,524 parturients were identified after combining the data from the systematic review. No cases of epidural hematoma requiring surgical decompression were observed. The upper bound of the 95% confidence interval for the risk of epidural hematoma for a platelet count of 0-49,000 mm −3 is 11%, for 50,000-69,000 mm −3 is 3%, and for 70,000-100,000 mm −3 is 0.2%.Conclusions-The number of thrombocytopenic parturients in the literature who received neuraxial techniques without complication has been significantly increased. The risk of epidural hematoma associated with neuraxial techniques in parturients at a platelet count <70,000 mm −3 remains poorly defined due to limited observations.

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Section: Resultsmentioning

confidence: 99%

Risk of Epidural Hematoma After Neuraxial Techniques in Thrombocytopenic Parturients: A Report From the Multicenter Perioperative Outcomes Group

Lee¹,

Bateman²,

Kheterpal³

et al. 2018

Obstetric Anesthesia Digest

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Physiological changes of pregnancy

Campbell

2000

Seminars in Anesthesia, Perioperative Medicine and Pain

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Risk of Epidural Hematoma after Neuraxial Techniques in Thrombocytopenic Parturients

et al. 2017

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Background Thrombocytopenia has been considered a relative or even absolute contraindication to neuraxial techniques due to the risk of epidural hematoma. There is limited literature to estimate the risk of epidural hematoma in thrombocytopenic parturients. The authors reviewed a large perioperative database and performed a systematic review to further define the risk of epidural hematoma requiring surgical decompression in this population. Methods The authors performed a retrospective cohort study using the Multicenter Perioperative Outcomes Group database to identify thrombocytopenic parturients who received a neuraxial technique and to estimate the risk of epidural hematoma. Patients were stratified by platelet count, and those requiring surgical decompression were identified. A systematic review was performed, and risk estimates were combined with those from the existing literature. Results A total of 573 parturients with a platelet count less than 100,000 mm–3 who received a neuraxial technique across 14 institutions were identified in the Multicenter Perioperative Outcomes Group database, and a total of 1,524 parturients were identified after combining the data from the systematic review. No cases of epidural hematoma requiring surgical decompression were observed. The upper bound of the 95% CI for the risk of epidural hematoma for a platelet count of 0 to 49,000 mm–3 is 11%, for 50,000 to 69,000 mm–3 is 3%, and for 70,000 to 100,000 mm–3 is 0.2%. Conclusions The number of thrombocytopenic parturients in the literature who received neuraxial techniques without complication has been significantly increased. The risk of epidural hematoma associated with neuraxial techniques in parturients at a platelet count less than 70,000 mm–3 remains poorly defined due to limited observations.

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Thromboelastographic Evaluation of Thrombocytopenic Parturients

Cited by 3 publications

References 0 publications

Risk of Epidural Hematoma After Neuraxial Techniques in Thrombocytopenic Parturients: A Report From the Multicenter Perioperative Outcomes Group

Risk of Epidural Hematoma After Neuraxial Techniques in Thrombocytopenic Parturients: A Report From the Multicenter Perioperative Outcomes Group

Physiological changes of pregnancy

Risk of Epidural Hematoma after Neuraxial Techniques in Thrombocytopenic Parturients

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