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Preeclampsia in 2017: Obstetric and Anaesthesia Management
Ross Hofmeyr1, Mushi Matjila2, Robert Dyer1
1Department of Anaesthesia & Perioperative Medicine, University of Cape Town, South Africa.
Insights
Preeclampsia management requires anesthesiologists to understand its pathophysiology and use ultrasound for severity assessment. Early detection and multidisciplinary care are crucial for effective perioperative medicine.
Area of Science:
- Anesthesiology
- Obstetrics
- Perioperative Medicine
Background:
- Preeclampsia is a significant perioperative medical challenge.
- Modern anesthesia practice integrates perioperative medicine.
- New definitions emphasize preeclampsia's rapid progression and early detection.
Purpose of the Study:
- To outline the anesthesiologist's role in managing preeclampsia.
- To highlight the importance of understanding preeclampsia pathophysiology.
- To emphasize the utility of ultrasound in assessing disease severity.
Main Methods:
- Review of current anesthetic practices for preeclampsia.
- Discussion of diagnostic and monitoring techniques, including ultrasound.
- Emphasis on multidisciplinary team collaboration.
Main Results:
- Anesthesiologists need to master preeclampsia pathophysiology and ultrasound skills.
- Regional anesthesia is key, with advancements in general anesthesia when needed.
- Hemodynamic monitoring and resuscitation leadership are vital.
Conclusions:
- Anesthesiologists play a critical role in the multidisciplinary management of preeclampsia.
- Early detection and accurate severity assessment guide anesthetic choices and perioperative care.
- Expertise in managing complications like cardiorespiratory failure and coagulopathy is essential.
Abstract:
In many centres, anaesthesia now incorporates perioperative medicine. Preeclampsia is a perioperative medical challenge requiring a multi-disciplinary team. New definitions stress the rapid progression of the disease and highlight the importance of early detection. Anaesthesiologists should understand the pathophysiology of the disease and develop the ultrasound skills required to assist in the assessment of disease severity. This facilitates the choice of anaesthesia method and perioperative management in complicated cases. Regional anaesthesia remains central, but there are important developments in the practice of general anaesthesia, if indicated. Appropriate haemodynamic monitoring should be established. Anaesthesiologists should also lead the resuscitation team in the management of cardiorespiratory failure and coagulopathy.
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