LAUSR

Historically, thrombocytopenia in pregnancy has been considered by many to be a relative contraindication to neuraxial placement secondary to the concern for spinal and epidural hematoma. More recent studies have attempted to further quantify this true risk by considering the etiology of thrombocytopenia and the absolute platelet count when epidurals were performed in parturients. We have described the most common etiologies of thrombocytopenia in pregnancy and the current tools available for bedside evaluation. We have reviewed the most recent literature and determined that multiple centers support the safe placement of neuraxial procedures in asymptomatic parturients with a platelet count >75,000 to 80,000/mm3 and even suggest that values above 60,000/mm3 could be acceptable in non-preeclamptic patients with thrombocytopenia depending on the specific etiology.