Randomized comparison of general and regional anesthesia for cesarean delivery in pregnancies complicated by severe preeclampsia

D. H. Wallace, K. J. Leveno, F. G. Cunningham, A. H. Giesecke, V. E. Shearer, J. E. Sidawi

Research output: Contribution to journalArticle

152 Citations (Scopus)

Abstract

Objective: To evaluate the maternal and fetal effects of three anesthetic methods used randomly in women with severe preeclampsia who required cesarean delivery. Methods: Eighty women with severe preeclampsia, who were to be delivered by cesarean, were randomized to general (26 women), epidural (27), or combined spinal-epidural (27) anesthesia. The mean preoperative blood pressure (BP) was approximately 170/110 mmHg, and all women had proteinuria. Anesthetic and obstetric management included antihypertensive drug therapy and limited intravenous (IV) fluid and drug therapy. Results: The mean gestational age at delivery was 34.8 weeks. All infants were born in good condition as assessed by Apgar scores and umbilical arterial blood gas determinations. Maternal hypotension resulting from regional anesthesia was managed without excessive IV fluid administration. Similarly, maternal BP was managed without severe hypertensive effects in women undergoing general anesthesia. There were no serious maternal or fetal complications attributable to any of the three anesthetic methods. Conclusion: General as well as regional anesthetic methods are equally acceptable for cesarean delivery in pregnancies complicated by severe preeclampsia if steps are taken to ensure a careful approach to either method.

Original languageEnglish (US)
Pages (from-to)193-199
Number of pages7
JournalObstetrics and Gynecology
Volume86
Issue number2
DOIs
StatePublished - 1995

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Conduction Anesthesia
Pre-Eclampsia
General Anesthesia
Anesthetics
Pregnancy
Mothers
Blood Pressure
Umbilicus
Drug Therapy
Apgar Score
Epidural Anesthesia
Fluid Therapy
Proteinuria
Intravenous Administration
Hypotension
Antihypertensive Agents
Gestational Age
Obstetrics
Gases

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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Randomized comparison of general and regional anesthesia for cesarean delivery in pregnancies complicated by severe preeclampsia. / Wallace, D. H.; Leveno, K. J.; Cunningham, F. G.; Giesecke, A. H.; Shearer, V. E.; Sidawi, J. E.

In: Obstetrics and Gynecology, Vol. 86, No. 2, 1995, p. 193-199.

Research output: Contribution to journalArticle

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AU - Shearer, V. E.

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