Uneventful Spinal Anesthesia in a Patient with Precipitous Drop of Platelet Secondary to HELLP Syndrome: A Case Report and Review of Literatures

Joe Z Liu, Chunhua Li, Hong Wang

Department of Anesthesiology, Detroit Medical Center, Detroit, Michigan, USA.

DOI: 10.4236/ojanes.2012.24031                

Abstract

Thrombocytopenia caused by Hemolysis, Elevated Liver enzymes and Low Platelet count (HELLP) syndrome in pre-eclampsia parturients can be associated with substantial maternal and neonatal morbidity. Data on the issue of the safety of neuraxial anesthesia with thrombocytopenia in HELLP syndrome is limited. A lower limit of 100,000 per microliter for platelet count was suggested as “safe” for performing neuraxial anesthesia, however there is no supporting data. This lower limit is challenged lately. We present a case of uneventful spinal anesthesia for urgent Cesarean section in a patient with severe pre-eclamsia, HELLP syndrome and precipitous platelet drop from 230,000 to 42,000 per microliter.

Keywords

Thrombocytopenia; Pre-eclampsia; HELLP Syndrome; Parturient; Cesarean Section; Platelet; Neuraxial Anesthesia; Neuraxial Hematoma

Conflicts of Interest

The authors declare no conflicts of interest.

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