Critical Care Obstetrics and Gynecology

Neuraxial Anesthesia in a COVID -19 Positive Pre-Eclamptic Parturient with Thrombocytopenia for Emergency Cesarean Section: An Anaesthetic Challenge

Background: With the increasing number of Coronavirus disease (COVID- 19) cases globally, we are faced with an unprecedented challenge of safe anesthetic management of parturient and health care personnel alike. Neuraxial anesthesia is the recommended choice for cesarean delivery in the COVID positive parturient unless otherwise contraindicated. The clinical manifestations of COVID-19 include Thrombocytopenia (Platelet count less than 150 × 109/L) and may influence the decision to administer neuraxial anesthesia for the fear of epidural hematoma. Other causes of thrombocytopenia in pregnancy include hypertensive disorders, gestational thrombocytopenia, and immune causes.

Case: In this case report, we have reviewed and presented the anesthetic management of a COVID-19 positive, pre-eclamptic parturient with thrombocytopenia posted for an emergency cesarean section.

Conclusion: The safe limit for platelet count for administering neuraxial anesthesia in COVID-19 positive parturient needs to be reconsidered and the single-shot subarachnoid block offers a safer alternative.

Author(s):

Prachi Agrawal^*, Bharti Wadhwa, Prachi Gaba and Kirti Saxena

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