A patient with HELLP syndrome has a platelet count of 42,000/µL at 30 weeks gestation. She is scheduled for cesarean delivery. What is the recommended minimum platelet count threshold for safe regional anesthesia (spinal/epidural)?

• A 20,000/µL
• B 50,000/µL ✓
• C 75,000/µL
• D 100,000/µL

Explanation

The generally accepted minimum platelet count threshold for regional anesthesia in obstetrics is 50,000-80,000/µL, with many guidelines recommending ≥50,000/µL as a safe minimum, though some anesthesiologists prefer ≥75,000/µL. Platelets below 50,000/µL increase the risk of epidural hematoma. A threshold of 20,000/µL is too low. 100,000/µL is unnecessarily restrictive.

Reference: Chestnut's Obstetric Anesthesia, 6th ed.

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