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Non-preeclamptic thrombocytopenia in pregnancy and neuraxial blockade: an OAA approved survey of practice

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Non-preeclamptic thrombocytopenia in pregnancy and neuraxial blockade: an OAA-approved survey of practice
 
M. Salman,1 J. Scott,2 SE. Robinson3

1 Specialist Registrar in Anaesthetics, 2 Consultant Anaesthetist, 3 Consultant Haematologist
 Guy’s and St. Thomas’ NHS Foundation Trust


Thrombocytopenia affects 7-10% of pregnant women.1 Gestational Thrombocytopenia (GTP) is the most common cause and can be indistinguishable from Immune Thrombocytopenia (ITP). Haemostatic abnormalities associated with reduced platelet count may increase the risk of vertebral canal haematoma (VCH) and may potentially preclude the use of regional anaesthesia.1 The platelet count at which central neuraxial blockade is perceived safe to administer remains controversial. Recent AAGBI guidance quotes no increase in the risk of VCH with CNB in ITP/GTP if the platelet count is >75 x 109/l.2


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