title: Focused review: spinal anesthesia in severe preeclampsia.
abstract: Spinal anesthesia is widely regarded as a reasonable anesthetic option for cesarean delivery in severe preeclampsia, provided there is no indwelling epidural catheter or contraindication to neuraxial anesthesia. Compared with healthy parturients, those with severe preeclampsia experience less frequent, less severe spinal-induced hypotension. In severe preeclampsia, spinal anesthesia may cause a higher incidence of hypotension than epidural anesthesia; however, this hypotension is typically easily treated and short lived and has not been linked to clinically significant differences in outcomes. In this review, we describe the advantages and limitations of spinal anesthesia in the setting of severe preeclampsia and the evidence guiding intraoperative hemodynamic management.
authors.affiliation: From the Department of Anesthesia, Stanford University School of Medicine, Stanford, California; and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Vanessa G
authors.initials: VG
authors.lastname: Henke
authors.forename: Brian T
authors.initials: BT
authors.lastname: Bateman
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Leffert
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001778:Blood Coagulation Disorders / Q000150:complications; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000209:etiology; D016343:Monitoring, Intraoperative; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy