Anesthesia for pregnancy-induced hypertension

Women with severe pregnancy-induced hypertension are often critically ill; their fetuses are usually compromised. An ideal anesthetic method does not exist for the parturient with severe hypertension, hypovolemia, and organ failure. Optimal anesthetic results depend upon thorough preanesthetic evaluation and best medical control of pathophysiology, regardless of the technique employed for vaginal or cesarean delivery. The anesthesia team must be consulted early, communicate freely and effectively with other perinatal team members, and have extensive knowledge of the pathophysiology involved. Time must be allowed for preparation of necessary monitoring and anesthetic facilities. In patients under good medical control, judiciously administered continuous epidural block is the better approach for labor, vaginal delivery, or cesarean section.