Abstract

CARDENAS, Antonia I. M; CARVAJAL, Jorge  and  LACASSIE, Héctor J. Manejo anestesiológico de pacientes con trastorno hipertensivo del embarazo. Rev. chil. obstet. ginecol. [online]. 2017, vol.82, n.1, pp.58-66. ISSN 0717-7526.  http://dx.doi.org/10.4067/S0717-75262017000100008.

Hypertensive Disorders of Pregnancy (HDP) contribute to maternal and fetal morbidity and mortality. In Chile, it is still the second leading cause of maternal death. The American (ACOG) and Canadian (SOGC) Societies of Obstetrics and Gynecology published an update of their hypertension guidelines in pregnancy, highlighting changes in definitions and diagnostic criteria. Modifications are revised in order to guide the anesthetic management of these patients. HDP can be classified into multiple categories, highlighting preeclampsia. Proteinuria is no longer required as diagnostic criteria. Severity features affect prognosis and should be actively searched. Interruption of pregnancy at 37 weeks is recommended, in the absence of signs of severity. Delivery should be determined by the obstetric conditions. Anesthetic management includes care of hypertensive crises, seizures, analgesia for labor and anesthesia for cesarean section. Early epidural analgesia is recommended in labor and spinal anesthesia for cesarean section. Intravenous fluids and invasive monitoring are not recommended due to increased complications risks.

Keywords : Preeclampsia; Hypertension; pregnancy; analgesia; anesthesia.

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