학술논문

The use of neuroaxial blockades in obstetric practice for thrombocytopenia
Document Type
article
Source
Инновационная медицина Кубани, Vol 0, Iss 4, Pp 72-78 (2019)
Subject
gestational thrombocytopenia
epidural hematoma
neuroaxial blockade
thromboelastography
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Diseases of the circulatory (Cardiovascular) system
RC666-701
Surgery
RD1-811
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
Language
Russian
ISSN
2541-9897
2500-0268
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.