Peripartum Management of Dual Antiplatelet Therapy and Neuraxial Labor Analgesia After Bare Metal Stent Insertion for Acute Myocardial Infarction | Zendy

Melissa E. Bauer | Zendy; Samuel Bauer | Zendy; Amir B. Rabbani | Zendy; Jill M. Mhyre | Zendy

Open Access

Peripartum Management of Dual Antiplatelet Therapy and Neuraxial Labor Analgesia After Bare Metal Stent Insertion for Acute Myocardial Infarction

Author(s) -

Melissa E. Bauer,

Samuel Bauer,

Amir B. Rabbani,

Jill M. Mhyre

Publication year - 2012

Publication title -

anesthesia and analgesia

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.404

H-Index - 201

eISSN - 1526-7598

pISSN - 0003-2999

DOI - 10.1213/ane.0b013e31825ab374

Subject(s) - medicine , eptifibatide , clopidogrel , thromboelastography , myocardial infarction , anesthesia , coronary stent , stent , surgery , percutaneous coronary intervention , cardiology , platelet , restenosis

A 31-year-old woman at 32 weeks' gestation presented with an ST segment elevation myocardial infarction with subsequent bare metal stent placement. A multidisciplinary team coordinated the delivery plan, including anticoagulation and delivery mode. Because the patient was at high risk for stent thrombosis, clopidogrel was discontinued after 4 weeks and bridged with eptifibatide for 7 days. Eptifibatide was stopped for induction of labor. Twelve hours after eptifibatide was discontinued, hemostatic function was assessed with thromboelastography before initiating neuraxial analgesia. A successful operative vaginal delivery was performed, followed by an uncomplicated recovery. Clopidogrel was resumed 24 hours postpartum.

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