Hypertension in Pregnancy

To the Editor: I had hoped that Cunningham and Lindheimer, in their review of hypertension during pregnancy (April 2 issue),¹ would revise the statement, made in an earlier article by Lindheimer and Katz,² that epidural anesthesia should be avoided in patients with severe preeclampsia — a statement that few obstetrical anesthesiologists would support. Unfortunately, they continue to quote the anesthesia literature selectively and have misrepresented the role of epidural anesthesia in this group of patients. First, in their discussion of general anesthesia, they mention the risks of hypertension associated with airway manipulation. What they fail to mention is the even…