Lumbar Epidural Analgesia to Improve Intervillous Blood Flow during Labor in Severe Preeclampsia

A new treatment of severe pre-eclampsia by long-term epidural anaesthesia

“…22,23 The sympathetic blockade achieved with epidural anaesthesia has been observed to cause vasodilatation in the lower body. Epidural anaesthesia significantly improves the placental blood flow in toxaemic pregnancies 18 and has been recommended as the method of choice in pre-eclamptic labours. [16][17][18][19][20] We reported that the stimulation of the sympathetic nerve induced pre-eclampsia-like phenomenon.…”

“…Epidural anaesthesia significantly improves the placental blood flow in toxaemic pregnancies 18 and has been recommended as the method of choice in pre-eclamptic labours. [16][17][18][19][20] We reported that the stimulation of the sympathetic nerve induced pre-eclampsia-like phenomenon. 13,14 Recently, we demonstrated that plasma from eclamptic and pre-eclamptic women stimulates the NE release in cultured sympathetic neuron and bupivacaine blunted the increase NE level that have been seen in stimulation with eclamptic and preeclamptic plasma.…”

“…15 Lumbar epidural anaesthesia, which blocks the abdominal sympathetic nerve, improves hypertension and biochemical parameters during pre-eclamptic labour. [16][17][18] Thus, epidural anaesthesia has been recommended by many authors as the analgesic method of choice in preeclamptic labour. 19,20 From these findings, we hypothesised that the stimulation of the abdominal sympathetic nerve is responsible for human preeclampsia.…”

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…Neither epidural nor combined spinal-epidural, analgesia harms the fetus [405,408,409] or increases Caesarean delivery in severe preeclampsia [410,411].…”

Maternal and fetal endocrine stress response at vaginal delivery with and without an epidural block

“…Conas well as arterial umbilical cord blood CA versely, epidural block is supposed to be benefihave been observed after vaginal delivery, and cial to the fetus since low maternal levels of CA especially in association with fetal acidosis [11, are associated with increased uterine blood flow 18]. [5,9]. In addition, the preserved ability of the fetus to respond to stress during labor after Catecholamine concentrations in venous cord epidural block ought to be a prerequisite for a blood originate mainly from fetus since there normal adaptation after birth.…”