General Anesthesia for Cesarean Delivery for Thrombocytopenia in Hypertensive Disorders of Pregnancy: Findings From the Obstetric Airway Management Registry
Authors' conclusion
In 17% of patients, the indication for GA was thrombocytopenia. Of these, 52 of 100, or nearly 9% of the total of 591, received GA because a platelet count was unavailable at the time of surgery.
Study context
- Population
- Patients receiving general anesthesia (GA) for cesarean delivery in the Obstetric Airway Management Registry (ObAMR), University of Cape Town-affiliated anesthesia training institutionscaptured in the registry
- Participants
- 591 patients
- Exposure
- Confirmed thrombocytopenia vs Suspected thrombocytopenia
- Confirmed thrombocytopenian = 48
- Suspected thrombocytopenian = 52
- Outcome
- Proportion of patients receiving GA for confirmed or suspected thrombocytopenia
Methodological detailsSubsequent platelet counts searched retrospectively in suspected thrombocytopenia, Algorithm with decision aid for risk vs benefit of spinal anesthesia (SA) vs GA proposed
- Subsequent platelet counts searched retrospectively in suspected thrombocytopenia
- Algorithm with decision aid for risk vs benefit of SA vs GA proposed
Main finding
As reported in the abstract
Thrombocytopenia as indication for GA
- Thrombocytopenia was the indication for GA (100 of 591)
- 16.9%
Observational data: associations, not effects.
Further findings
- Platelet counts retrospectively traced (suspected thrombocytopenia)
- 88.5% · 46 of 52
- Platelet counts retrospectively traced (suspected thrombocytopenia): 46 of 52
Platelet count, retrospectively traced suspected thrombocytopenia cases
- Median (IQR 93 - 233 × 10 9 /L) platelet count
- 178 × 10 9 /L
- 46 retrospectively traced counts
Platelets >75 × 10 9 /L, retrospectively traced suspected thrombocytopenia cases
- Platelets exceeded 75 × 10 9 /L in 41 of 46
- 89.1%
Diagnoses in retrospectively confirmed thrombocytopenia (5 of 46)
- HELLP syndrome
- 2
- Antepartum hemorrhage with preeclampsia
- 2
- Isolated thrombocytopenia with preeclampsia
- 1
GA potentially avoidable (platelet count >75 × 10 9 /L), all registry patients
- 41 of 591 had a platelet count >75 × 10 9 /L and would not have needed GA
- 6.9%
Original publication
General Anesthesia for Cesarean Delivery for Thrombocytopenia in Hypertensive Disorders of Pregnancy: Findings From the Obstetric Airway Management Registry. Anesth Analg. Published 13 October 2022. doi:10.
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