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S. Choi and R. Brull, “Neuraxial Techniques in Obstetric and Non-Obstetric Patients with Common Bleeding Diatheses,” Anesthesia and Analgesia, Vol. 109, No. 2, 2009, pp. 648-660. doi:10.1213/ane.0b013e3181ac13d1

has been cited by the following article:

• TITLE: Uneventful Spinal Anesthesia in a Patient with Precipitous Drop of Platelet Secondary to HELLP Syndrome: A Case Report and Review of Literatures

  AUTHORS: Joe Z Liu, Chunhua Li, Hong Wang

  KEYWORDS: Thrombocytopenia; Pre-eclampsia; HELLP Syndrome; Parturient; Cesarean Section; Platelet; Neuraxial Anesthesia; Neuraxial Hematoma

  JOURNAL NAME: Open Journal of Anesthesiology, Vol.2 No.4, September 5, 2012

  ABSTRACT: Thrombocytopenia caused by Hemolysis, Elevated Liver enzymes and Low Platelet count (HELLP) syndrome in pre-eclampsia parturients can be associated with substantial maternal and neonatal morbidity. Data on the issue of the safety of neuraxial anesthesia with thrombocytopenia in HELLP syndrome is limited. A lower limit of 100,000 per microliter for platelet count was suggested as “safe” for performing neuraxial anesthesia, however there is no supporting data. This lower limit is challenged lately. We present a case of uneventful spinal anesthesia for urgent Cesarean section in a patient with severe pre-eclamsia, HELLP syndrome and precipitous platelet drop from 230,000 to 42,000 per microliter.