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Adding to the Denominator: A Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension.
A A Pract. 2020 Mar 01; 14(5):144-148.P

Abstract

The acceptable platelet count for the safe provision of neuraxial anesthesia in obstetric patients is unknown. Comorbidities may sway a provider to perform neuraxial anesthesia, despite thrombocytopenia, as the putative risk of spinal-epidural hematoma may not outweigh the risks associated with general anesthesia. The case of a 22-year-old nulliparous woman undergoing a cesarean delivery with a new diagnosis of pulmonary hypertension and right heart failure, compounded with thrombocytopenia and possible Hemolysis, Elevated Liver Enzyme, and Low Platelet (HELLP) syndrome, is presented. Risks and benefits of general versus neuraxial anesthesia in this specific setting are reviewed.

Authors+Show Affiliations

From the Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.Department of Anesthesiology.Department of Anesthesiology.Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology.Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology.Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York.Department of Anesthesiology.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31977323

Citation

Meng, Marie-Louise, et al. "Adding to the Denominator: a Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension." A&A Practice, vol. 14, no. 5, 2020, pp. 144-148.
Meng ML, Bernstein K, Hussey P, et al. Adding to the Denominator: A Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension. A A Pract. 2020;14(5):144-148.
Meng, M. L., Bernstein, K., Hussey, P., Emeruwa, U. N., Mourad, M., Haythe, J., & Landau, R. (2020). Adding to the Denominator: A Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension. A&A Practice, 14(5), 144-148. https://doi.org/10.1213/XAA.0000000000001168
Meng ML, et al. Adding to the Denominator: a Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension. A A Pract. 2020 Mar 1;14(5):144-148. PubMed PMID: 31977323.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adding to the Denominator: A Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension. AU - Meng,Marie-Louise, AU - Bernstein,Kyra, AU - Hussey,Patrick, AU - Emeruwa,Ukachi N, AU - Mourad,Mirella, AU - Haythe,Jennifer, AU - Landau,Ruth, PY - 2020/1/25/pubmed PY - 2020/10/22/medline PY - 2020/1/25/entrez SP - 144 EP - 148 JF - A&A practice JO - A A Pract VL - 14 IS - 5 N2 - The acceptable platelet count for the safe provision of neuraxial anesthesia in obstetric patients is unknown. Comorbidities may sway a provider to perform neuraxial anesthesia, despite thrombocytopenia, as the putative risk of spinal-epidural hematoma may not outweigh the risks associated with general anesthesia. The case of a 22-year-old nulliparous woman undergoing a cesarean delivery with a new diagnosis of pulmonary hypertension and right heart failure, compounded with thrombocytopenia and possible Hemolysis, Elevated Liver Enzyme, and Low Platelet (HELLP) syndrome, is presented. Risks and benefits of general versus neuraxial anesthesia in this specific setting are reviewed. SN - 2575-3126 UR - https://www.unboundmedicine.com/medline/citation/31977323/Adding_to_the_Denominator:_A_Case_Report_of_Neuraxial_Anesthesia_for_Cesarean_Delivery_in_the_Setting_of_Hemolysis_Elevated_Liver_Enzyme_Low_Platelet_Thrombocytopenia_and_Pulmonary_Hypertension_ L2 - https://doi.org/10.1213/XAA.0000000000001168 DB - PRIME DP - Unbound Medicine ER -