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Epidural Catheter Falling Platelets — FRCA Final MCQ

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HardObstetric AnaesthesiaEpidural Catheter Falling PlateletsFRCA Final

A parturient with pre-eclampsia has a working epidural. Her platelet count drops from 110 to 55 over 6 hours. What is the priority regarding the epidural catheter?

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Correct answer: D — Check coagulation screen and TEG before deciding on removal timing

With rapidly falling platelets (110→55/6h in pre-eclampsia/HELLP), epidural catheter removal is as risky as insertion when platelets are low. Check full coagulation including fibrinogen and viscoelastic testing. Time removal when platelet count is rising (after delivery and treatment), ideally >75. Multidisciplinary decision.

Reference: OAA – 2023 – Epidural management in pre-eclampsia with falling platelets