Updates in Preeclampsia

Abstract

Hypertensive disorders of pregnancy, specifically preeclampsia, cause significant morbidity and mortality in both the mother and fetus. Changes in the diagnostic criteria have attempted to improve the ability to identify and initiate treatment. Recently, it has been discovered that a placenta-derived anti-angiogenic environment directly contributes to the pathological cause of preeclampsia. The early identification of these anti-angiogenic markers may enhance diagnosis of the disease in the future. Patients with preeclampsia need to be treated with caution in regard to airway and coagulation; however, neuraxial anesthesia, when appropriate, is preferred. During labor, the increase in placental blood flow secondary to epidural analgesia can improve fetal perfusion. Spinal and epidural anesthesia are safe for cesarean delivery in mothers with preeclampsia, and may be preferred over general anesthesia. Preeclampsia is a complex disorder that impacts day to day decisions of anesthesia care provider.