الفهرس 
Introduction
Preoperative assessmentOnly 14 pages are availabe for public view
Abstract
Pregnancy-Induced hypertension (PIH) is also called toxemia of the pregnancy or pre-eclampsia. It occurs most often in young women with first pregnancy. It is more common in twin pregnancies, in women with chronic hypertension, pre-existing diabetes, and in women who had PIH in a previous pregnancy. Eclampsia is a severe form of PIH. The hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity. Cerebral hemorrhage is the major cause of maternal mortality in preeclampsia and any increases in maternal blood pressure above 160 mmHg or at induction of general anesthesia should be treated.
The chief role of the anesthetist is to provide safe labour analgesia and anesthesia for caesarean section. Anesthetists also play a key role in resuscitation and intensive care management, including provision of invasive monitoring and limitation of cardiorespiratory, cerebral and renal complications. The therapy of choice includes the use of magnesium for prevention of seizures and antihypertensive medications to decrease severe hypertension. Regional anesthesia is the mainstay of therapy both in labour and for caesarean section, in the absence of contraindications.
The potential pitfalls of general anesthesia, including failed intubation, in these complicated patients make regional anesthesia the preferred choice in many cases. Recent studies have shown that spinal anesthesia is often appropriate for preeclamptic patients, even in severe cases. The benefits of epidural analgesia in labour are well established. Nevertheless, it is important to be aware of the potential contraindications to neuraxial anesthesia and to prepare for the possibility of encountering a difficult airway.
Management of the preeclamptic parturient includes adequate foetal monitoring, management of hypertension, prevention of seizures, active management of labour, maintenance of uteroplacental perfusion, and provision of adequate analgesia for labour and safe anesthesia for operative delivery.