Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Case Report

Thromboelastography as a point-of-care guide for spinal anesthesia in an eclamptic patient: a case report

Tromboelastografia como orientação à beira-leito para raquianestesia em paciente com eclâmpsia: relato de caso

Vendhan Ramanujam, Usama Iqbal, Mary Im

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Neuraxial anesthesia is a standard of care during parturition. Since bleeding diathesis is a contraindication to neuraxial techniques, data about its safe administration in a thrombocytopenic milieu is limited and evolving. Thrombocytopenia associated with preeclampsia or eclampsia and hemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome leads to significant maternal and neonatal morbidity. We present a case of uneventful spinal anesthesia for urgent cesarean section in an eclamptic patient with a precipitous drop in platelet count from 124,000 to 97,000 per cubic millimeter under thromboelastography (TEG) guidance.


Thrombocytopenia Cesarean section Thromboelastography Neuraxial anesthesia Preeclampsia Eclampsia


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