This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Describe the risks of neuraxial vs general anesthesia in pregnancy
2. Discuss the recommendations for the use of neuraxial anesthesia in the setting of maternal thrombocytopenia
Estimated time to complete activity: 0.25 hours
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Ashley Comfort, MD, has a financial interest in Pfizer and has no other conflicts of interest to disclose.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from 3/31/2022 through 3/31/2024, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the test and evaluation. Upon registering and successfully completing the test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.25 contact hours.Read Disclaimer & Fine Print
The Society for Obstetric Anesthesia and Perinatology (SOAP) commissioned a consensus document on the topic of neuraxial procedures in the context of thrombocytopenia. The following professional bodies were included: American Society of Regional Anesthesia and Pain Medicine (ASRA), ACOG, SMFM, and the American Society for Hematology (ASH). The panel was convened to address an ongoing issue where obstetric patients with thrombocytopenia are often denied neuraxial anesthesia due to risk of spinal epidural hematoma. However, there are significant maternal and fetal risks associated with general anesthesia during pregnancy.
Note: For more information on thrombocytopenia in pregnancy including etiologies and management, see ‘Related ObG Topics’ below
Neuraxial Anesthesia: Thrombocytopenia-Related Spinal Henatoma
Risks Associated with General Anesthesia
We found no evidence from RCTs or non‐randomised studies on which to base an assessment of the correct platelet transfusion threshold prior to insertion of a lumbar puncture needle or epidural catheter
…clinicians and patients should engage in shared decision-making about the perceived competing risks/benefits of proceeding with or withholding neuraxial anesthesia in cases of severe thrombocytopenia and concurrent aspirin use
The Society for Obstetric Anesthesia and Perinatology Interdisciplinary Consensus Statement on Neuraxial Procedures in Obstetric Patients with Thrombocytopenia
SOAP Thrombocytopenia Consensus Statement FINAL
Cochrane Review: Use of platelet transfusions prior to lumbar punctures or epidural anaesthesia for the prevention of complications in people with thrombocytopenia
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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