Levy N, et al. - Laboring women with low platelet counts may be denied neuraxial block due to concerns about causing a spinal-epidural hematoma. In this current investigation, the anesthetic management, complications and outcome variables of laboring women with low platelet counts were retrospectively assessed, along with the safety of neuraxial blocks in this patient population. Findings supported that the risk of hematoma is low if the platelet count is <100 000/μL, specifically if between 70 and 99 000/μL.

• Researchers retrospectively analyzed anesthetic and obstetric data from women with platelet counts < 100 000/μL, who were admitted to a single referral center during 2011-2014.
• The rate of neuraxial block and related complications were examined in relation to the platelet count and the results combined with published data to assess the risk of spinal epidural hematoma.

• A low platelet count (<100 000/μL) was observed during the study period in 471 of 45 462 women (1%).
• Researchers found that in women with platelet counts of 70-99 000/μL (280/394, 71.1%), the rate of neuraxial block was significantly higher in comparison to women with platelet counts of 50-69 000/μL and 0 to 49 000/μL (23/59, 38.9% and 5/18, 27.8%, respectively, P<0.0001).
• A higher risk of cesarean delivery under general anesthesia and longer hospital stay were reported in women in the lower platelet ranges.
• Additionally, no neuraxial hematoma were reported.