TY - CHAP M1 - Book, Section TI - Neuraxial Anesthesia in Parturients on Anticoagulation A1 - I. Colella, Merry A2 - Hess, Philip E. A2 - Li, Yunping A2 - Kowalczyk, John J. A2 - Stiles, Justin K. Y1 - 2023 N1 - T2 - Obstetric Anesthesia: Quick References & Practical Guides AB - Anticoagulation is a vital intervention to prevent venous thromboembolism and related maternal morbidity and mortality.The use of anticoagulation in parturients is becoming increasingly more common and has a substantial impact on the use and timing of neuraxial anesthetic procedures.As of yet, no professional society has published firm guidelines that adequately address the increased risk of epidural hematoma in anticoagulated obstetric patients. The American Society of Regional Anesthesia and Pain Medicine (ASRA) guidelines minimally differentiate between pregnant and nonpregnant patients and so do not account for the hypercoagulable state of pregnancy.1In a recent systematic review, an analysis of 52 parturients whose anticoagulation was not held for the recommended period prior to a neuraxial procedure did not find a single documented incidence of spinal epidural hematoma.2Using ASRA guidelines in an obstetric population would likely result in an inappropriate number of parturients being denied or delayed for neuraxial anesthesia, which leads to greater complications in those patients from the use of general anesthesia.The following guideline for parturients on unfractionated heparin (UFH) regimens is based on both a consensus statement from the Society for Obstetric Anesthesia and Perinatology,3 related ASRA guidelines, and the experience of our senior staff.Establishing good communication with the patient, the obstetric team, and the nursing staff during both the antepartum period and upon the patient’s arrival to the labor and delivery unit is essential and will aid in the adequate delivery of appropriate anesthetic care for labor analgesia in this patient population. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1199673573 ER -