Preeclampsia and the anaesthesiologist: current management.

Area of Science:

• Obstetrics and Gynecology
• Anesthesiology
• Critical Care Medicine

Background:

• Preeclampsia is a significant contributor to maternal and neonatal morbidity and mortality.
• Current research focuses on angiogenic biomarkers for diagnosis and prognosis.
• Effective management involves a multidisciplinary approach, including pain relief, anesthesia, and critical care.

Purpose of the Study:

• To review the role of angiogenic biomarkers in preeclampsia diagnosis and management.
• To discuss the analgesic, anesthetic, and critical care strategies for preeclamptic patients.
• To highlight recent advancements in monitoring and treating preeclampsia.

Main Methods:

• Review of current literature on angiogenic biomarkers (placental growth factor, soluble fms-like tyrosine kinase-1).
• Analysis of anesthetic techniques, including neuraxial blocks and general anesthesia.
• Evaluation of critical care monitoring, such as transthoracic echocardiography.

Main Results:

• Angiogenic biomarkers aid in preeclampsia diagnosis and management.
• Neuraxial blocks are recommended unless contraindicated; safe platelet thresholds are still under investigation.
• Phenylephrine is a viable alternative to ephedrine for managing spinal hypotension.
• Blunting the hypertensive response during general anesthesia is crucial.
• Transthoracic echocardiography is valuable for hemodynamic monitoring.

Conclusions:

• Improved diagnostic tools for preeclampsia can enhance maternal and neonatal outcomes.
• Peripartum care for preeclampsia necessitates a multidisciplinary team.
• Neuraxial analgesia/anesthesia is frequently used.
• Severe preeclampsia cases require critical care support meeting high standards.