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ESRA19-0157 Coagulopathy due to obstetric cholestasis in patients undergoing regional techniques
  1. DK Meessala1,
  2. G Bose2 and
  3. FJ Emerantia Jacintha1
  1. 1The Royal Wolverhampton NHS Trust, Department of Anaesthesia, Wolverhampton, UK
  2. 2University Hospital of North Midlands NHS Trust, Department of Anaesthesia, Stoke-on-Trent, UK


Background and aims Obstetric cholestasis affects 0.7% of pregnancies in multi-ethnic women. Coagulopathy may develop due to decreased vitamin K absorption which is needed for activating clotting factors in obstetric cholestasis. The Association of Anaesthetists of Great Britain and Ireland guidelines recommends to check coagulation before any regional techniques in these patients. We have done an audit in our hospital to evaluate our practice of testing for coagulation and to compare with national guidelines.

Methods We have collected data retrospectively after approval from our audit department. We have collected data of patients who were diagnosed with obstetric cholestasis from June 2016 to May 2018. The data collected on excel sheet are number of patients who had coagulation tests done, number of patients who had regional techniques, number of patients who had coagulation tests done within 24 hrs of regional technique and number of patients with INR (international normalised ratio) >1.4.

Results We conducted an analysis of 175 patients. Details are shown in table 1.

Conclusions We are less compliant with national guidelines as 27 (41%) of patients had coagulation tests done during antenatal period and 10 patients had tests done within 24 hrs of regional technique. Our recommendations are that coagulation tests to be done on admission to delivery suite, we update our local guidelines after discussion with obstetricians and re-audit.

Abstract ESRA19-0157 Table 1

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