Coagulation screening before epidural analgesia in pre-eclampsia.
 A questionnaire survey of current practice at a small cross-section of obstetric units, covering 22% of all United Kingdom deliveries, revealed a marked lack of standard practice regarding requests for coagulation screens on pre-eclamptic patients who require epidural procedures.
 A retrospective audit was therefore carried out on 434 coagulation screens requested for pre-eclamptic patients in whom epidural analgesia might have been considered.
 Borderline abnormalities of coagulation were found in only 10 patients (2%).
 Platelet counts of less than 150 x 10(9)/litre were present in 28% of cases.
 'Significant' thrombocytopenia (less than 100 x 10(9)/litre) and all coagulation abnormalities were only encountered in severe pre-eclampsia (diastolic blood pressure of greater than 110 mmHg and proteinuria of + + or greater).
 Furthermore, coagulation abnormality was always associated with a reduced platelet count (mean, 97 x 10(9)/litre).
 This study would therefore support anaesthetic practice which restricted any requests for coagulation testing to severe pre-eclamptic patients only.
 For these patients first line testing could be limited to a platelet count.
