Thrombocytopenia, low molecular weight heparin, and obstetric anesthesia

The parturient with coagulation defects, whether related to thrombocytopenia or to anticoagulation therapy, presents a unique challenge to the anesthesiologist. The risk of spinal or epidural hematoma in these patients has not been quantified fully but is a factor that one must consider on a case-by-case basis in determining whether neuraxial anesthesia is appropriate for the parturient. Following the guidelines set forth in this article should help reduce the risk of spinal or epidural hematoma without sacrificing the quality of care provided to patients.