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Diagnosis and management of pre-eclampsia: an update.
MedLine Citation:
PMID:  21151680     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Pre-eclampsia is a significant, multifactorial, multiorgan disease affecting 5%-8% of all pregnancies in the US where it is the third leading cause of maternal mortality. Despite improvements in the diagnosis and management of pre-eclampsia, severe complications can occur in both the mother and the fetus, and there is no effective method of prevention. Early detection and identification of pregnant women most at risk of developing the disease have proven challenging, but recent efforts combining biochemical and biophysical markers are promising. Efforts at prevention of pre-eclampsia with aspirin and calcium have had limited success, but research on modifiable risk factors, such as obesity surgery, are encouraging. Obstetric management of severe pre-eclampsia focuses on medical management of blood pressure and prevention of seizures using magnesium sulfate, but the ultimate cure remains delivery of the fetus and placenta. Timing of delivery depends on several factors, including gestational age, fetal lung maturity, and most importantly, disease severity. Anesthetic management includes regional anesthesia with careful evaluation of the patient's airway, volume status, and coagulation status to reduce morbidity and mortality. The potential complications of general anesthesia, including intracranial hemorrhage, in these patients make regional anesthesia the preferred choice in many cases. Nevertheless, it is important to be aware of the contraindications to neuraxial anesthesia and to prepare always for the possibility of encountering a difficult airway.
Authors:
Judi A Turner
Publication Detail:
Type:  Journal Article     Date:  2010-09-30
Journal Detail:
Title:  International journal of women's health     Volume:  2     ISSN:  1179-1411     ISO Abbreviation:  Int J Womens Health     Publication Date:  2010  
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-04-05     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101531698     Medline TA:  Int J Womens Health     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  327-37     Citation Subset:  -    
Affiliation:
Department of Anesthesiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. jaturner@mednet.ucla.edu
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