P.115 Timing is everything: Labour epidurals and anticoagulants

Abstract

Introduction: The latest MBRRACE report advocates the need for pregnant women on prophylactic and treatment dose anticoagulation to have a structured management plan during the peripartum period. [1] Knight M, Bunch K, Tuffnell D, et al. (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care – Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2016 – 18. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2020. Google Scholar In our district general hospital, peripartum documentation is a mix of paper and electronic records. Further to this all drug prescriptions are charted on an electronic system. An Association of Anaesthetists guideline exists for the timing of neuraxial anaesthesia and anticoagulants. [2] AAGBI: Regional anaesthesia and patients with abnormalities of coagulation 2013. https://anaesthetists.org/Home/Resources-publications/Guidelines. Google Scholar This is pertinent on the labour ward where epidurals are commonplace and patients are often prescribed anticoagulation. Clear communication within the labour ward multidisciplinary team (MDT) is paramount in ensuring the safe timing of neuraxial anaesthesia. There are serious implications if these guidelines are not followed which could have devastating consequences for the patient.