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Summary

From the anesthesiologist’s point of view, the first contact with the parturient is usually during labor or cesarean section and delivery. In this situation, the time spent in volume preloading, blood pressure control, stabilization of the mother’s condition, and choice of anesthetic or analgesia technique is time well spent.3,41 Such preparation will often reduce fetal and maternal morbidity.6 Consequently, it is imperative that the anesthetist be warned early of such women presenting for delivery.

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References

  1. Magee LA, Ornstein MP, von Dadelszen P. Management of hypertension in pregnancy. BMJ 1999;318:1332–1336.

    CAS  PubMed  Google Scholar 

  2. Maruk F, Moodley J. Maternal and neonatal outcome in early-and late-onset preeclampsia. Semin Neonatol 2000;5:3:197–207.

    Article  Google Scholar 

  3. Gatt S. Pre-eclampsia. In: Birnbach DJ (ed) Ostheimer’s Manual of Obstetric Anesthesia, 3rd edn. New York: Saunders/Harcourt Brace, 1999.

    Google Scholar 

  4. Walker JJ. Pre-eclampsia. Lancet 2000;356:1260–1295.

    Article  CAS  PubMed  Google Scholar 

  5. Mörtl MG, Schneider MC. Key issues in assessing, managing and treating patients presenting with severe preeclampsia. Int J Obstet Anesth 2000;9:39–44.

    Article  Google Scholar 

  6. Gatt S. Clinical management of established pre-eclampsia/gestational hypertension: perspectives of the midwife, neonatologist and anesthetist. In: Brown M (ed) Bailliè;re’s Clinical Obstetrics and Gynaecology, Pregnancy and Hypertension Edition: Baillère’s Best Practice and Research, vol 13. London: Baillère Tindall, 1999;95–105.

    Google Scholar 

  7. Salonen-Ros H, Lichtenstein P, Lipworth L, Cnattingius S. Genetic effects on the liability of developing pre-eclampsia and gestational hypertension. Am J Med Genet 2000;91:256–260.

    Article  CAS  PubMed  Google Scholar 

  8. Broughton-Pipkin F. What is the place of genetics in the pathogenesis of preeclampsia? Biol Neonate 2000;76:325–330.

    Article  Google Scholar 

  9. Lie R, Rasmussen S, Brunborg H, et al. Fetal and maternal contributions to risk of preeclampsia: population-based study. BMJ 1998;316:1343–1347.

    CAS  PubMed  Google Scholar 

  10. Higgins JR, de Swiet M. Blood-pressure measurement and classification in pregnancy. Lancet 2001;357:131–135.

    Article  CAS  PubMed  Google Scholar 

  11. Schneider MM, Landau R, Mörtl MM. New insights in hypertensive disorders of pregnancy. In: Obstetric & Gynecologic Anaesthesia: Baillere’s Best Practice & Research. London: Lippincott Williams & Wilkins, 2001:291–297.

    Google Scholar 

  12. Schobel H, Fischer T, Geiger H, Schmieder R. Preeclampsia: a state of sympathetic overactivity. N Engl J Med 1996;335(20):1480–1485.

    Article  CAS  PubMed  Google Scholar 

  13. Easterling TR, Benedetti TJ, Schmucker BC, et al. Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study. Obstet Gynecol 1990;76:1061.

    CAS  PubMed  Google Scholar 

  14. Mattar F, Sibai BM. Eclampsia: risk factors for maternal morbidity. Am J Obstet Gynecol 2000;182:307–312.

    Article  CAS  PubMed  Google Scholar 

  15. Lo YM. Fetal DNA in maternal plasma. Ann NY Acad Sci. 2000;46: 1903–1906.

    CAS  Google Scholar 

  16. Ohkuchi A, Minakami H, Sato I, et al. Predicting the risk of pre-eclampsia and small for gestational age infant by quantitative assessment of the diastolic notch in uterine artery flow velocity waveforms in unselected women. Ultrasound Obstet Gynecol 2000;16:171–178.

    Article  CAS  PubMed  Google Scholar 

  17. Aquilina J, Barnett A, Thompson O, Harrington K. Comprehensive analysis of uterine artery flow velocity waveforms for the prediction of pre-eclampsia. Ultrasound Obstet Gynecol 2000;16:163–170.

    Article  CAS  PubMed  Google Scholar 

  18. Holzgreve W, Li JC, Steinborn A, et al. Elevation in erythroblast count in maternal blood before the onset of pre-eclampsia. Am J Obstet Gynecol 2001;184:165–168.

    Article  CAS  PubMed  Google Scholar 

  19. Bosio P, McKenna P, Conroy R, O’Herlihy C. Maternal central hemodynamics in hypertensive disorders of pregnancy. Obstet Gynecol 1999; 94:978–984.

    Article  CAS  PubMed  Google Scholar 

  20. United Kingdom Health Department. Why Mothers Die. A Report on the Confidential Enquiries into Maternal Deaths in the United Kingdom 1994–1996 CEMD Triennium. London: Stationery Office, 1999.

    Google Scholar 

  21. Stone P, Cook D, Hutton J, et al. Measurements of blood pressure, oedema and proteinuria in a pregnant population of New Zealand. Aust N Z J Obstet Gynecol 1995;35:32–37.

    CAS  Google Scholar 

  22. Saphier CJ, Repke JT. Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome: a review of diagnosis and management. Semin Perinatol 1998;22(2):118–133.

    CAS  PubMed  Google Scholar 

  23. Onrust S, Santema JG, Aarnoudse JG. Pre-eclampsia and the HELLP syndrome still cause maternal mortality in the Netherlands and other developed countries; can we reduce it? Eur J Obstet Gynecol Reprod Biol 1999;82(1):41–46.

    Article  CAS  PubMed  Google Scholar 

  24. Sheikh RA, Yasmeen S, Pauly MP, Riegler JL. Spontaneous intrahepatic hemorrhage and hepatic rupture in HELLP syndrome: four cases and a review. J Clin Gastroenterol 1999;28(4):323–328.

    Article  CAS  PubMed  Google Scholar 

  25. Anumba DO, Robson SC. Management of pre-eclampsia and haemolysis, elevated liver enzymes, and low platelets syndrome. Curr Opin Obstet Gynecol 1999;11:sn2:149–156.

    Article  CAS  PubMed  Google Scholar 

  26. Jones SL. HELLP: a cry for laboratory assistance: a comprehensive review of the HELLP syndrome highlighting the role of the laboratory. Hematopathol Mol Hematol 1998;11(3):147–171.

    CAS  PubMed  Google Scholar 

  27. Maalati K, Dawson RB, Collins JO, et al. Persistent preeclampsia post partum with elevated liver enzymes and hemolytic uremic syndrome. J Clin Apheresis 1999;14:(2):69–78.

    Article  Google Scholar 

  28. Curtin WM, Weinstein L. A review of HELLP syndrome. J Perinatol 1999;19(2):138–143.

    Article  CAS  PubMed  Google Scholar 

  29. Clark SL, Cotton DB, Lee W, et al. Central hemodynamic assessment of normal pregnancy. Am J Obstet Gynecol 1989;161(6):1439–1442.

    CAS  PubMed  Google Scholar 

  30. Wasserstrum N, Cotton DB. Hemodynamic monitoring in severe pregnancy-induced hypertension. Clin Perinatol 1986;13:781.

    CAS  PubMed  Google Scholar 

  31. Cotton DB, Gonik B, Doman KF, et al. Cardiovascular alterations in severe pregnancy induced hypertension: relationship of central venous pressure to pulmonary capillary wedge pressure. Am J Obstet Gynecol 1985; 151:762.

    CAS  PubMed  Google Scholar 

  32. Newsome LR, Bramwell RS, Curling PE. Hemodynamics in severe preeclamptics. Anesth Analg 1986;65:33.

    Google Scholar 

  33. Cotton DB, Lee W, Huhta JC, et al. Hemodynamic profile of severe pregnancy induced hypertension. Am J Obstet Gynecol 1988;158:523–529.

    CAS  PubMed  Google Scholar 

  34. Schindler M, Gatt S, Isert P, et al. Thrombocytopenia and platelet functional defects in preeclampsia: implications for regional anaesthesia. Anaesth Intensive Care 1990;18:169.

    CAS  PubMed  Google Scholar 

  35. Williams K. Hypertension in pregnancy. Can Family Physician 1995;41: 626–632.

    CAS  Google Scholar 

  36. World Health Organisation. International Society of Hypertension guide-lines for the management of hypertension. J Hypertens 1999;17:151–183.

    Google Scholar 

  37. Gallery ED. Hypertension in pregnancy. Practical management recommendations. Drugs 1995;49(4):555–562.

    Article  CAS  PubMed  Google Scholar 

  38. Mastrobattista JM. Angiotensin converting enzyme inhibitors in pregnancy. Semin Perinatol 1997;21(2):124–134.

    CAS  PubMed  Google Scholar 

  39. Drug and Therapeutics Information Service. National Prescribing Service (NPS) News 1999;6:3.

    Google Scholar 

  40. Burrows RF, Burrows EA. Assessing the teratogenic potential of angiotensin-converting enzyme inhibitors in pregnancy. Aust N Z J Obstet Gynecol 1998;38:306–309.

    CAS  Google Scholar 

  41. Gatt SP. Gestational proteinuric hypertension. Curr Opin Anesthesiol 1991;5:354–359.

    Article  Google Scholar 

  42. Lydakis C, Lip GY, Beevers M, Beevers DG. Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens 1999;12: 541–547.

    Article  CAS  PubMed  Google Scholar 

  43. Australian Drug Evaluation Committee, Government Department of Health and Family Services. Australian Categorization of Risk of Drug Use in Pregnancy: Prescribing Medicines in Pregnancy, 4th edn. Canberra: Australian Government Publishing Service, 1999:1–59.

    Google Scholar 

  44. Walters BNJ, Redman CWG. Treatment of severe pregnancy-associated hypertension with the calcium antagonist nifedipine. Br J Obstet Gynecol 1981;21:11–15.

    Google Scholar 

  45. Gallery EDM, Ross M, Györy AZ. Antihypertensive treatment in pregnancy: analysis of different responses to oxprenolol and methyldopa. Br Med J 1985;291:563–566.

    Article  CAS  Google Scholar 

  46. Chadwick HS, Easterling T. Anesthetic concerns in the patient with preeclampsia. Semin Perinatol 1991;15(5):397–409.

    CAS  PubMed  Google Scholar 

  47. Pritchard JA, Cunningham FG, Pritchard SA. The Parkland Memorial Hospital protocol for the treatment of eclampsia: evaluation of 245 cases. Am J Obstet Gynecol 1984;148:951.

    CAS  PubMed  Google Scholar 

  48. Naulty S, Cefalo RC, Lewis PE. Fetal toxicity of nitroprusside in the pregnant ewe. Am J Obstet Gynecol 1981;139:708.

    CAS  PubMed  Google Scholar 

  49. CDC Surveillance Summary. Maternal mortality in pregnancy in the USA from 1980 to 1985: US maternal mortality surveillance, 1980–85. MMWR 1988.

    Google Scholar 

  50. Guidelines Clearing House Statement “Hypertension.” Summary and recommendations for a rational hypertension guideline in Germany. Z Arzt Fortbd Qualitatssich 2000;94:5:341–349.

    Google Scholar 

  51. Van Hook JW. Management of complicated preeclampsia. Semin Perinatol 1999;23(1):79–90.

    PubMed  Google Scholar 

  52. CLASP: a randomised trial of low dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. Lancet 1994; 343:619–629.

    Google Scholar 

  53. Duley L, Williams J, Henderson-Smart DJ. Plasma volume expansion for treatment of women with pre-eclampsia. Cochrane Database Syst Rev 2000;2:CD001805.

    PubMed  Google Scholar 

  54. Hofmeyr GJ. Prophylactic intravenous preloading for regional analgesia in labour. Cochrane Database Syst Rev 2000;2:CD000175.

    PubMed  Google Scholar 

  55. Van den Elzen HJ, Wladimiroff JW, Overbeek TE, et al. Calcium metabolism, calcium supplementation and hypertensive disorders of pregnancy. Eur J Obstet Gynecol Reprod Biol 1995;59(1):5–16.

    Article  PubMed  Google Scholar 

  56. Brown MA, Zammit VC, Mitar DM. Extracellular fluid volumes in pregnancy-induced hypertension. J Hypertens 1992;10:61–68.

    CAS  PubMed  Google Scholar 

  57. Brown MA, Gallery EDM, Gatt SP, et al. Consensus statement. Management of hypertension in pregnancy, consensus statement of the Australasian Society for the Study of Hypertension in Pregnancy. Executive summary. Med J Aust 1993;158:700–702.

    Google Scholar 

  58. Brown MA, Hague WM, Higgins J, et al. The detection, investigation and management of hypertension in pregnancy. Executive summary and full consensus statement. Aust NZ J Obstet Gynecol 2000;40(2):133–155.

    CAS  Google Scholar 

  59. Clark SL, Horenstein JM, Phelan JP, et al. Experiences with the pulmonary artery catheter in obstetrics and gynecology. Am J Obstet Gynecol 1985;152:374.

    CAS  PubMed  Google Scholar 

  60. Gilbert WM, Towner DR, Field NT, Anthony J. The safety and utility of pulmonary artery catheterisation in severe pre-eclampsia and eclampsia. Am J Obstet Gynecol 2000;182:(6):1397–1403.

    Article  CAS  PubMed  Google Scholar 

  61. Gatt S. What has been happening on the pre-eclampsia front in the last few years? In: Abstract Book. Continuing Education Conference Australian and New Zealand College of Anaesthetists, New Zealand Society of Anaesthetists and Australian Society of Anaesthetists, 1999, p 41.

    Google Scholar 

  62. Appleton MP, Kuehl TJ, Raebel MA, et al. Magnesium sulfate versus phenytoin for seizure prophylaxis in pregnancy-induced hypertension. Am J Obstet Gynecol 1991;165:907–913.

    CAS  PubMed  Google Scholar 

  63. Clark SL, Greenspoon JS, Aldahl D, et al. Severe pre-eclampsia with persistent oliguria: management of hemodynamic subsets. Am J Obstet Gynecol 1986;154:490.

    CAS  PubMed  Google Scholar 

  64. Lyall F, Greer IA. Pre-eclampsia: a multifaceted vascular disorder of pregnancy. J Hypertens 1994;13:1339–1345.

    Google Scholar 

  65. Gatt S. Hypertensive disorders and renal disease in pregnancy and labour. In: Birnbach D, Gatt S, Datta S (eds) Obstetric Anesthesia New York: Harcourt, 2000.

    Google Scholar 

  66. Witlin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol 1998;92:5:883–889.

    Article  CAS  PubMed  Google Scholar 

  67. Duley L, Gulmezoglu AM, Henderson-Smart DJ. Anticonvulsants in women with pre-eclampsia. Cochrane Database Syst Rev 2000;2: CD000025.

    PubMed  Google Scholar 

  68. Hood D, Curry R. Spinal versus epidural anesthesia for cesarean section in severely preeclamptic patients. Anaesthesia 1999;9(5):1276–1283.

    Google Scholar 

  69. Lao TT, Halpern SH, MacDonald D, Huh C. Spinal subdural haematoma in a parturient after attempted epidural anaesthesia. Can J Anaesth 1993;40:340–345.

    Article  CAS  PubMed  Google Scholar 

  70. Overdyk FJ, Harvey SC. Continuous spinal anesthesia for cesarean section in a parturient with severe preeclampsia. J Clin Anesth 1998;10: 510–513.

    Article  CAS  PubMed  Google Scholar 

  71. Wallace DH, Leveno KJ, et al. Randomised comparison of general and regional anesthesia for cesarean delivery in pregnancies complicated by severe preeclampsia. Obstet Gynecol 1995;86:2.

    Article  Google Scholar 

  72. Orlikowski CEP, Rocke DA, Murray WB, et al. Thromboelastography changes in pre-eclampsia and eclampsia. Br J Anaesth 1996;77:157–161.

    CAS  PubMed  Google Scholar 

  73. Burrows RF, Kelton JG. Fetal thrombocytopenia and its relation to maternal thrombocytopenia. N Engl J Med 1993;329:1463–1466.

    Article  CAS  PubMed  Google Scholar 

  74. Gatt S. A platelet count of less than 75×109/L is a contraindication to lumbar epidural anesthesia—how low can you, go? [Abstract]. Anesthesiology 2000.

    Google Scholar 

  75. Beilin Y, Bodian CA, Haddad EM, Leibowitz AB. Practice patterns of anesthesiologists regarding situations in obstetric anesthesia where clinical mangement is controversial. Anesth Analg 1996;83:735–741.

    Article  CAS  PubMed  Google Scholar 

  76. Warren E, Lyons G, Columb MO, Gorton H. Thrombocytopenia, regional blockade and thromboelastography. Eur Soc Meet Abstr 2000;A498.

    Google Scholar 

  77. Channing Rodgers RP, Levin J. A critical reappraisal of the bleeding time. Semin Thromb Hemostasis 1990;16:1.

    Article  Google Scholar 

  78. Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 1995;345:1455–1463.

    Google Scholar 

  79. Idama TO, Lindow SW. Magnesium sulphate: a review of clinical pharmacology applied to obstetrics. Br J Obstet Gynecol 1998;105(3):260–268.

    CAS  Google Scholar 

  80. Lucas MJ, Leveno KJ, Cunningham FG, et al. A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. N Engl J Med 1995;333(4):201–251.

    Article  CAS  PubMed  Google Scholar 

  81. Sibai BM, Kustermann L, Velasco J. Current understanding of severe preeclampsia, pregnancy-associated hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, hemolysis, elevated liver enzymes, and low platelet syndrome, and postpartum acute renal failure: different clinical syndromes or just different names? Curr Opin Nephrol Hypertens 1994;3(4):436–445.

    CAS  PubMed  Google Scholar 

  82. Gartner HV, Sammoun A, Wehrmann M, et al. Preeclamptic nephropathy—an endothelial lesion. A morphological study with a review of the literature. Eur J Obstet Gynecol & Reprod Biol 1998;77(1):11–27.

    Article  CAS  Google Scholar 

  83. Aguglia U, Tinuper P, Farnarier G, et al. Electroencephalographic and anatomoclinical evidence of posterior cerebral damage in hypertensive encephalopathy. Clin Electroencephalogr 1984;15:53–60.

    CAS  PubMed  Google Scholar 

  84. Saito Y, Tano Y. Retinal pigment epithelial lesions associated with choroidal ischemia in preeclampsia. Retina 1998;19:(3):262–263.

    Google Scholar 

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Gatt, S.P., Elliott, D. (2004). Preeclampsia and Eclampsia. In: Datta, S., Hepner, D.L. (eds) Anesthetic and Obstetric Management of High-Risk Pregnancy. Springer, New York, NY. https://doi.org/10.1007/0-387-21572-7_19

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  • DOI: https://doi.org/10.1007/0-387-21572-7_19

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