Epidural hematoma following low molecular weight heparin prophylaxis and spinal anesthesia for cesarean delivery

Abstract

Epidural hematoma is a very uncommon complication of spinal anesthesia. Its incidence has been reported to be between 1:200 000-250 000 in the obstetric population following neuraxial anesthesia. Cesarean delivery increases the risk of maternal venous thromboembolism significantly and recommendations to decrease its incidence and morbidity have been developed. Strategies to decrease venous thromboembolism include pharmacologic prophylaxis with unfractionated or low molecular weight heparin. We report a case of spinal-epidural hematoma occurring in a parturient who received spinal anesthesia for a planned, repeat cesarean delivery after low molecular weight heparin thromboprophylaxis.

Keywords: Complications of regional anesthesia; Deep venous thrombosis prophylaxis; Epidural hematoma; Low molecular weight heparin; Spinal anesthesia; Thromboembolism.