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Hypertensive disorders in pregnancy.

Madhusudan Upadya¹, Sumesh T Rao¹

¹Department of Anaesthesia, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India.

Indian Journal of Anaesthesia

|September 22, 2018

Summary

Hypertensive disorders of pregnancy (HDP) affect 7.8% of women in India, posing significant anesthetic challenges. Effective management focuses on safe delivery and maternal/fetal well-being.

Keywords:

HELLP syndrome Hypertensive disorders of pregnancy eclampsia magnesium sulphate pre-eclampsia

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Area of Science:

Obstetrics and Gynecology
Anesthesiology
Maternal-Fetal Medicine

Background:

Hypertensive disorders of pregnancy (HDP) represent a major unresolved obstetric challenge.
HDP affects 7.8% of pregnant women in India, with pre-eclampsia at 5.4%.
These disorders impact multiple maternal systems, complicating anesthetic management.

Purpose of the Study:

To outline the anesthetic considerations and management strategies for Hypertensive Disorders of Pregnancy.
To ensure optimal outcomes for both mother and fetus in cases of HDP.
To provide a comprehensive approach to managing severe pre-eclampsia.

Main Methods:

Review of anesthetic challenges in HDP affecting cardiovascular, respiratory, neurologic, renal, hepatic, and uteroplacental systems.
Discussion of obstetric management including fetal surveillance and timely delivery.
Emphasis on antihypertensive and anticonvulsant therapy, safe labor analgesia, and anesthesia for delivery.

Main Results:

Anesthetic management in HDP requires a multidisciplinary approach.
Key objectives include facilitating a healthy infant's birth and maternal recovery.
Minimizing trauma during delivery in severe pre-eclampsia is paramount.

Conclusions:

Comprehensive management of HDP involves obstetric care, fetal monitoring, and tailored anesthetic strategies.
Antihypertensive and anticonvulsant therapies are crucial components of care.
Safe analgesia and anesthesia for delivery are essential for positive maternal and fetal outcomes.