HEMOSTASIS ASSESSMENT BEFORE EPIDURAL ANA LGESIA FOR PARTURITION - A FRENCH NATIONWIDE SURVEY

Objectives: To specify by which means French anaesthesiologists evalua te the haemostasis profile of pregnant women before epidural analgesia . Study design: Nationwide retrospective survey. Material: Questionnai re sent to 847 French obstetrical units. Methods: Comparison of catego rial qualitative parameters using a chi(2) test. Results: Answers from 435 centres, including 1,834 anaesthesiologists, performing 227 x 10( 3) epidurals for 411 x 10(3) deliveries/year were obtained. A preanaes thetic clinical assessment was performed systematically in two out of three units, and blood samples for PT, aPTT and platelet count were ta ken in more than 90% of the centres. These laboratory examinations wer e often made during the 9th month of pregnancy (74%). For more than on e-third of the anaesthesiologists, biological data are not essential b efore epidural puncture. In addition, the lower limits considered as b eing safe before epidural puncture were highly variable between the te ams. Conclusions: Coagulation laboratory tests are almost always order ed before epidural obstetrical analgesia in France. The rationale to p erform them is not always related to pregnancy induced haemostatic cha nges. Therefore, this problem should be clarified by a consensus confe rence for both practical and economical reasons.