Hassan Badawy
Abdulla Bin Omran Maternity Hospital, Egypt
Title: Thrombocytopenia in pregnancy, Anesthetist concerns
Biography
Biography: Hassan Badawy
Abstract
Thrombocytopenia complicates 10% of pregnancies as a result of several etiologic factors. Th rombocytopenia may be
preexisting or can develop as a result of the pregnancy. Th rombocytopenia that develops aft er 20 weeks gestation may
be a sign of preeclampsia. However, most thrombocytopenia in pregnancy is benign, gestational thrombocytopenia. Platelet
count is expected to decrease by approximately 10% in normal pregnancy. Autoimmune thrombocytopenia, anti-phospholipid
syndrome, and liver disease are less common. No platelet count is universally accepted as safe for neuraxial anesthesia. Most
anesthesiologists agree that neuraxial anesthesia in the setting of a platelet count greater than 100,000/mm is safe and neuraxial
anesthesia with platelets less than 50,000/mm is unsafe. Disagreement exists about the safety of neuraxial anesthesia at platelet
counts between 50 and 100,000/ mm. Management of anesthesia in obstetric patients should not be based on a single parameter
in pregnant women with severe thrombocytopenia. Besides the platelet count, other laboratory fi ndings should be paired with
TEG and clinical fi ndings and a decision should be rendered aft er considering the patient-specifi c risks and benefi ts regarding
the use of general or regional anesthesia.