Perioperative management of preeclampsia during cesarean delivery focuses on reducing maternal complications through hypertension control, organ preservation, and tailored anesthesia strategies.
This comprehensive review outlines perioperative management strategies to reduce maternal complications in patients with preeclampsia undergoing cesarean delivery, emphasizing the need for long-term cardiometabolic follow-up.
Preeclampsia is a common condition of pregnancy characterized by hypertension complicated by cerebral, cardiac, hepatic, renal, hematologic, and placental dysfunction. Patients with preeclampsia frequently undergo cesarean delivery, the most common major surgical procedure in the world. They represent a high-risk perioperative cohort suffering significant preventable morbidity and mortality. This review focuses on the anesthesiologist's role, through a perioperative lens, in reducing maternal complications through management of hypertension and strategies for preserving the function of the brain, heart, liver, kidney, hematologic and coagulation systems, and placenta in patients with preeclampsia undergoing cesarean delivery. Preeclampsia-specific resuscitation, individualized fluid administration, safe neuraxial and general anesthesia, and management of intraoperative bleeding are discussed along with strategies for postoperative analgesia, thromboprophylaxis, and antihypertensive agents in patients who breastfeed. This review discusses recently recognized postoperative deterioration in maternal mental health, the possibility of myocardial injury after cesarean delivery, and the need for long-term cardiometabolic follow-up.
Dennis et al. (Tue,) conducted a review in Preeclampsia. Perioperative management was evaluated. Perioperative management of preeclampsia during cesarean delivery focuses on reducing maternal complications through hypertension control, organ preservation, and tailored anesthesia strategies.