Objective: To assess complications arising from regional analgesia for obstetric labor and delivery in women with idiopathic thrombocytopenic purpura (ITP).
Material and methods: Retrospective study of case records of women with ITP who gave birth at our hospital over the 10-year period from 1993 through 2002. Quality control checklists were applied to case records before including them for study. The chart had to contain information on the type of analgesia/anesthesia used during labor or cesarean section, the results of complete peripartum coagulation tests, and a record of the presence or absence of anesthetic complications. Twenty-eight births involving 24 patients with ITP were studied.
Results: Regional analgesia/anesthesia, usually by epidural infusion, was the technique most often used. All patients had prothrombin and cephalin times within the normal ranges. Regional analgesia/anesthesia was never used in cases where the platelet count was less than 70,000/mm3. In such cases, general anesthesia was used for cesareans, with endovenous administration of opioids. No analgesia was used when the patient declined it for normal deliveries. Eleven cesarean deliveries and 17 vaginal deliveries were recorded. No complications were observed either with regional or endovenous techniques.
Conclusions: The regional neuroaxial techniques used in this series of women with ITP, in whom platelet counts exceeded 70,000/mm3, were not associated with hemorrhagic complications.