Preeclampsia and eclampsia: Enhanced detection and treatment for morbidity reduction

Best Pract Res Clin Anaesthesiol. 2024 Sep;38(3):246-256. doi: 10.1016/j.bpa.2024.11.001. Epub 2024 Nov 19.

Abstract

Preeclampsia is a life-threatening complication that develops in 2-8% of pregnancies. It is characterized by elevated blood pressure after 20 weeks of gestation and may progress to multiorgan dysfunction, leading to severe maternal and fetal morbidity and mortality. The only definitive treatment is delivery, and efforts are focused on early risk prediction, surveillance, and severity mitigation. Anesthesiologists, as part of the interdisciplinary team, should evaluate patients early in labor in order to optimize cardiovascular, pulmonary, and coagulation status. Neuraxial techniques are safe in the absence of coagulopathy and aid avoidance of general anesthesia, which is associated with high risk in these patients. This review aims to provide anaesthesiologists with a comprehensive update on the latest strategies and evidence-based practices for managing preeclampsia, with an emphasis on perioperative care.

Keywords: Anesthesiology; Blood pressure; Eclampsia; Hypertensive disorders of pregnancy; Preeclampsia; Pregnancy.

Publication types

  • Review

MeSH terms

  • Anesthesia, Obstetrical / methods
  • Eclampsia* / diagnosis
  • Eclampsia* / epidemiology
  • Eclampsia* / prevention & control
  • Eclampsia* / therapy
  • Female
  • Humans
  • Morbidity / trends
  • Perioperative Care / methods
  • Pre-Eclampsia* / diagnosis
  • Pre-Eclampsia* / therapy
  • Pregnancy