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Case Reports
Epidural Analgesia in a Preeclamptic Parturient After Normalization of a Prolonged Bleeding Time With DDAVP
  1. Regina Y. Fragneto, M.D.* and
  2. Sanjay Datta, M.D.†
  1. *Department of Anesthesiology, Medical College of Virginia, Richmond, Virginia,
  2. †Obstetric Anesthesia, Brigham and Women's Hospital, and Department of Anesthesia, Harvard Medical School, Boston, Massachusetts
  1. Reprint requests: Regina Y. Fragneto, M.D., Department of Anesthesiology, Medical College of Virginia, P.O. Box 980695, Richmond, VA 23298-0695.

Abstract

Background and Objectives. Despite several advantages to the use of epidural analgesia for the management of labor pain in preeclamptic parturients, this procedure is withheld from many such patients owing to associated thrombocytopenia and platelet dysfunction.

Methods. A preeclamptic parturient with mild thrombocytopenia and platelet dysfunction manifested by a prolonged bleeding time received intravenous DDAVP (0.3 μg/kg) in an attempt to correct her coagulation abnormality.

Results. The patient's bleeding time was normalized with DDAVP administration, allowing her to receive epidural analgesia.

Conclusions. Preeclampsia-induced platelet dysfunction might be corrected with DDAVP. A controlled study is required before its routine use can be advocated.

  • preeclampsia
  • thrombocytopenia
  • bleeding time
  • DDAVP
  • epidural analgesia

https://doi.org/10.1136/rapm-00115550-199520050-00014

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    Footnotes

    • Dr. Fragneto was affiliated with Brigham and Women's Hospital at the time this case study was conducted.