Analgesia use among 984 women with preeclampsia: A retrospective observational single-center study

Study objective: To determine the incidence of platelet count <100,000 mm⁻³ and percentage decrease in platelet count in the 72 h prior to delivery in women with preeclampsia. Design: Retrospective analysis of all women with preeclampsia who presented to the labor floor during calendar years 2012–2015. Setting: Academic medical center in New York City, United States. Patients: Nine hundred and eighty four women with preeclampsia. Measurements: Data collected included all platelet counts recorded for a period of 72 h prior to delivery. Demographic data, laboratory data including complete blood count with platelets, blood urea nitrogen (BUN) Creatinine (CR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), International Normalization Ratio (INR), and fibrinogen level, placement of neuraxial anesthesia and presence of epidural hematoma were also recorded. Main results: We identified 984 women with preeclampsia who had a median presenting platelet count of 195,000 mm⁻³ [151,000–233,000] and a final platelet count of 193,000 mm⁻³ [147,000–233,000]. Platelets did not decrease significantly over the 72 h with a median change of 0 [−8–5.0] and a median % change of 0 [−4.1–2.6]. 64 (6.5%) patients had a platelet count <100,000 mm⁻³, 21 (2.1%) had a platelet count <70,000 mm⁻³, and 5 (0.5%) had a platelet count <50,000 mm⁻³. Neuraxial anesthesia was placed in 40/64 women with platelet count <100,000 mm⁻³ and there were no cases of epidural or spinal hematoma. Conclusions: These findings suggest that the incidence of thrombocytopenia in women with preeclampsia, especially platelet count <70,000 mm⁻³, is uncommon as is further decrease in platelet count after admission.