RESUMEN
OBJECTIVE: To determine whether pre-eclamptic patients receiving spinal anaesthesia require prior coagulation screening studies. METHODS: This was a retrospective study of all patients with pre-eclampsia receiving spinal anaesthesia during the period January 1995 to March 2001. The control group was patients without pre-eclampsia who also received spinal anaesthesia. A total of 240 patients were studied, 134 in the pre-eclamptic group and 106 controls. The results reported are the mean ñ standard deviation, and range; p< 0.005 was considered significant. RESULTS: The mean age of the pre-eclamptic women was 28 ñ 5.7 years compared with 30 ñ 5.4 years for the controls (p= 0.029). The mean platelet count for the pre-eclamptics was 205.7 ñ 68.0 x 10/1 (range 23.0-394.0 x 10/1) while the mean platelet count of the controls was 204.5 ñ 43.6 x 10/1 (range 150.0-339.0 x 10/1) (p= 0.873). Differences between mild pre-eclamptic and severe pre-eclamptic subgroups were also evaluated. Mean age and haemoglobin levels between the two subgroups were no different (p= 0.370 and p= 0.310, respectively) but the mean platelet count was significantly lower (p= 0.002) in the severe pre-eclamptic subgroup. Coagulation testing included prothrombin time (PT) and partial thromboplastin time (PTT). There was a significant difference in PTT between mild and severe pre-eclamptics (p= 0.013) but no correlation between abnormally low platelet counts and abnormal coagulation times was demonstrated (p= 0/751. r= -0.063). Overall, there was no difference between the groups in outcome variables, including any intermediate or long-term neurological deficits. CONCLUSIONS: Data from this study therefore support limiting the coagulation screening in pre-eclamptics to patients who demonstrate a diminished platelet count. (AU)