What are the International Consensus Report recommendations for obstetric analgesia and anesthesia in women with immune thrombocytopenia (ITP)?

Updated: Jan 11, 2020
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Recommendations for obstetric analgesia and anesthesia in women with ITP include the following [40] ​:

  • At a platelet count ≥70 × 10 9/L, in the absence of other hemostatic abnormalities, regional axial anesthesia can be safely performed.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided for postpartum or postoperative analgesia in women with platelet counts < 70 × 10 9/L because of increased hemorrhagic risk.
  • A platelet count ≥50 × 10 9/L should be obtained for delivery.
  • All women, despite having ITP, who are at an increased risk for thromboembolism should receive appropriate prophylaxis for venous thromboembolism.
  • The mother with a rapidly falling platelet count should be observed more closely than those with low, but stable, levels.

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