Adding to the Denominator: A Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension.

Journal Article (Journal Article)

The acceptable platelet count for the safe provision of neuraxial anesthesia in obstetric patients is unknown. Comorbidities may sway a provider to perform neuraxial anesthesia, despite thrombocytopenia, as the putative risk of spinal-epidural hematoma may not outweigh the risks associated with general anesthesia. The case of a 22-year-old nulliparous woman undergoing a cesarean delivery with a new diagnosis of pulmonary hypertension and right heart failure, compounded with thrombocytopenia and possible Hemolysis, Elevated Liver Enzyme, and Low Platelet (HELLP) syndrome, is presented. Risks and benefits of general versus neuraxial anesthesia in this specific setting are reviewed.

Full Text

Duke Authors

Cited Authors

  • Meng, M-L; Bernstein, K; Hussey, P; Emeruwa, UN; Mourad, M; Haythe, J; Landau, R

Published Date

  • March 1, 2020

Published In

Volume / Issue

  • 14 / 5

Start / End Page

  • 144 - 148

PubMed ID

  • 31977323

Electronic International Standard Serial Number (EISSN)

  • 2575-3126

Digital Object Identifier (DOI)

  • 10.1213/XAA.0000000000001168


  • eng

Conference Location

  • United States