Author/Authors :
Sargın, A Ege Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Ana Bilim Dalı, Turkey , Karaman, S Ege Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Kılınç, N Ege Üniversitesi - Tıp Fakültesi - Anestezi ve Reanimasyon Ana Bilim Dalı, Turkey , Günüşen, İ Ege Üniversitesi - Tıp Fakültesi - Anesteziyoloji ve Reanimasyon Anabilim Dalı, Turkey , Akdemir, A Ege Üniversitesi - Tıp Fakültesi - Kadın Hastalıkları ve Doğum Anabilim Dalı, Turkey
Abstract :
Aim: Studies investigating a minimum “safe” platelet level for regional block are on going. Our aim is to evaluate methods of anesthesia and limits of regional anesthesia practice of pregnant patients with a history of thrombocytopenia under going cesarean section.Materials and Methods: The data of pregnant patients with thrombocytopenia under going cesarean section between 2006-2011, were analyzed retrospectively. The data of 51 patients, including maternal age at delivery, gestational age at delivery, gravidity, parity, nature of cesarean, and obstetric additional diseases were recorded. Also, information including hemoglobin, hematocrite, platelet levels, coagulation parameters, steroid or IVIG use, blood and/or thrombocyte placement treatment during preoperative and postoperative period, the method of anesthesia and postoperative complications were collected.Results: In the study, a total number of 51 pregnant women with thrombocytopenia gave birth to 51 healthy babies by cesarean delivery. Elective and emergency cesareans comprised 52.9% and of 47.1% all cesareans, respectively. The onset time of thrombocytopenia among the 51 cases, i.e, 3 cases (5.9%), 4 cases (7.8%), 1 case (2%), 43 cases (84.3%) of thrombocytopenia were detected in the pregestational time, first, second and third trimester, respectively. Of these 51 pregnant patients, 78.4% and 21.6% of received general anesthesia or spinal anesthesia, respectively. The lowest platelet count for spinal anesthesia was 87,000μL-1 comparing to the level of 24,000μL-1 for general anaesthesia during the preoperative period.Conclusion: We suggest that regional anestesia may be a safe method with careful monitoring for pregnant patients with severe trombocytopenia. However, decisions on the safest method of anesthesia in preparation for delivery should be made with a multidisciplinary team involving the obstetrician, hematologist, and anesthesiologist.
