Anesthesia in pregnant women with HELLP syndrome

Abstract

We found no documentation of any neurologic or hematologic complications of women with HELLP syndrome and neuraxial anesthesia.

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…These women should be assessed soon after the block has worn off to exclude back pain or new/progressive neurological complications [432]. s Thrombocytopoenia Neuraxial haematomas have not been reported with platelet counts above 75 Â 10 9 /L, in the absence of platelet dysfunction or associated coagulopathy [434]. Practice varies widely regarding an acceptable platelet count (range 50-100 Â 10 9 /L) prior to neuraxial anaesthesia or catheter removal [413,435] s Aspirin Women on low-dose aspirin (60-81 mg) are eligible for neuraxial anaesthesia [436,437].…”

Anesthetic practices for patients with preeclampsia or HELLP syndrome: A survey

“…Moreover, epidural anesthesia was the preferred method in those complicated cases (24,25). Vigil-De Gracia and colleagues reported 36 patients with HELLP syndrome with platelet counts below 100,000/µL who received regional anesthesia and no epidural hematoma was suffered by any of the patients (12 patients had platelet counts below 50,000/µL) (26). None of those patients with HELLP syndrome in the study by Vigil-De Gracia (26) had disseminated intravascular coagulation and abnormal indices.…”

Anesthetic management of HELLP syndrome complicating primary antiphospholipid syndrome -A case report-

“…Among them 12 patients who received a neuroaxial block had platelet counts less than 50 × 10 3 /ml without neurologic and hematolic complications or bleeding in the epidural space. Thus, Vigil-De Gracia et al [11] recommended that neuroaxial anesthesia may be safely administered in the patients with HELLP syndrome without disseminated intravascular coagulopathy or prolonged PT/aPTT. However, our patient had both low platelet counts and prolonged aPTT while on heparin.…”