The use of neuroaxial blockades in obstetric practice for thrombocytopenia
https://doi.org/10.35401/2500-0268-2019-16-4-72-78
Abstract
Thrombocytopenia is the second most frequent hematological complication of pregnancy after anemia. Among all thrombocytopenia during pregnancy, the most common is gestational thrombocytopenia. Gestational thrombocytopenia is not accompanied by coagulation disorders, has a minimal risk of bleeding, for both a mother and her fetus. Nevertheless, according to modern concepts, thrombocytopenia is a contraindication for performing obstetric neuroaxial blockades only on the basis of quantitative count of platelets, without taking into account coagulation status. These contraindications are derived from the general surgery and traumatology practice due to the high risk of developing epidural hematoma, but do not take into account the features, including physiological hypercoagulation, of pregnant patients. Refusal of the patient to perform a neuroaxial blockade during delivery on the basis of only counting the number of platelets often leads to an unreasonable increase in the risk / benefit ratio for both the mother and the fetus. Analysis of the research results indicates a change in attitude towards this problem towards a more loyal approach, taking into account the assessment of the coagulative status of a particular patient.
About the Authors
E. N. Plakhotina
Vidnovsky Perinatal Center
Russian Federation
Russian Federation
Plakhotina Elena N. – Dr. of Sci. (Med.), Head of Anaesthesiology and Resuscitation
142700, Moscow Region, Vidnoe, 17, Zavodskaya str.
T. N. Belousova
Vidnovsky Perinatal Center
Russian Federation
Russian Federation
Belousova Tamara N. – Cand. of Sci. (Med.), Сhief doctor
142700, Moscow Region, Vidnoe, 17, Zavodskaya str.
N. B. Kuzina
Vidnovsky Perinatal Center
Russian Federation
Russian Federation
Kuzina Natalia B. – Anaesthesiologist-Resuscitator of the Department of Anesthesiology and Resuscitation
142700, Moscow Region, Vidnoe, 17, Zavodskaya str.
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Review
For citations:
Plakhotina E.N., Belousova T.N., Kuzina N.B. The use of neuroaxial blockades in obstetric practice for thrombocytopenia. Innovative Medicine of Kuban. 2019;(4):72-78. (In Russ.) https://doi.org/10.35401/2500-0268-2019-16-4-72-78
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