Progression of pre-eclampsia to eclampsia under spinal anesthesia

Abstract

Pre-eclampsia and eclampsia are hypertensive disorders of pregnancy that cause significant morbidity and mortality in the fetus and mother. Globally, pre-eclampsia and eclampsia account for 10-15% of maternal deaths.Pre-eclampsia is a multi-organ group of related disease processes that occur in up to 5-8% of pregnancies after 20 weeks of gestation. The presentation is variable, but generally includes the combination of maternal hypertension and proteinuria. Eclampsia is the new onset of grandmal seizures occurring during and after pregnancy that do not have another identifiable cause.The development of eclampsia is associated with increased risk of adverse outcome for both mother and fetus. Preeclamptic patients may present to the labor and delivery unit with or without a prior diagnosis of preeclampsia and may pose a significant anesthetic challenge. The administration of general anesthesia (GA) in such high risk parturients may cause exaggerated cardiovascular response to intubation leading to cerebral hemorrhage and edema, cardiovascular decompensatio