Anesthetic practices for patients with preeclampsia or HELLP syndrome: A survey

Objective: substantial controversy exists regarding anesthetic management for patients with preeclampsia or hemolysis,elevated liver enzymes,low platelet count (hellp) syndrome. experts,researchers,clinicians,and residents in turkey were surveyed about their practices. material and methods: questionnaires were distributed to attendees at a national conference,and they were filled out immediately. anonymous 10-item paper surveys were administered to both residents and non-residents. descriptive statistics were used in the analysis. agreement among ≥75% of the respondents was considered a majority opinion. surveys with missing responses were used to analyze the non-response bias. the chisquare test was used for comparisons. a historical cohort of obstetricians–gynecologists was used for comparison with anesthesiologists. results: of 339 surveys distributed,288 were returned (84.9% response rate). among the returned surveys,the completion rate was 96.1%. the job experience in years among clinicians and residents was 9±5 and 3±1,respectively. general anesthesia was still significantly preferred by 36.1% among patients with preeclampsia with platelet counts of ≥100,000/μl. compared to obstetricians–gynecologists,anesthesiologists more often preferred general anesthesia. with platelet counts of <50,000/μl or eclampsia,most respondents preferred general anesthesia 94.4% for very low platelets and 89.5% for eclampsia. conclusion: a preferential trend toward general anesthesia for patients with preeclampsia or hellp syndrome exists among anesthesiologists in turkey,particularly for patients with severe thrombocytopenia and/or eclampsia. there exists a need for well-designed and well-executed prospective clinical trials to provide evidence for the best consensus practice. © 2016 by the turkish-german gynecological education and research foundation.