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Preeclampsia and anaesthesia

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Preeclampsia and anaesthesia

Postby caryn » Tue Mar 31, 2009 02:46 pm

by caryn (10124 Posts), Tue Mar 31, 2009 02:46 pm

Cerebral haemorrhage is the major cause of maternal mortality in preeclampsia and any increases in maternal blood pressure above 160 mmHg or at induction of general anaesthesia should be treated. Traditional rapid sequence induction is, therefore, best avoided; neuraxial anaesthesia is the technique of choice...

http://www.ncbi.nlm.nih.gov/pubmed/19318931

So they like spinals, because they do a better job of stabilizing us and seem to be a safer option.

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Re : Preeclampsia and anaesthesia

Postby mother bear » Tue Mar 31, 2009 08:52 pm

by mother bear (270 Posts), Tue Mar 31, 2009 08:52 pm

When I was doing the 170/110 while lying on the left side thing, and they decided that as soon as possible was the right time for delivery, they actually did the C-section with a slow push epidural at just barely the level where it didn't hurt, not a spinal. They were extremely concerned that more anesthesia would lower the pressure and compromise fetal blood flow (placental abruption already). I'm sure if it wasn't a C-section, if it was induction instead, the same technique would be used, because they have more control over epidurals than spinals. But, I'm no doc.
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Re : Preeclampsia and anaesthesia

Postby caryn » Tue Mar 31, 2009 08:55 pm

by caryn (10124 Posts), Tue Mar 31, 2009 08:55 pm

You know, epidurals count here too, because they just say "neuraxial". :-) I read in "spinal" 'cause that's what I had!
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Re : Preeclampsia and anaesthesia

Postby mandyandhenry » Thu Apr 09, 2009 08:05 pm

by mandyandhenry (3 Posts), Thu Apr 09, 2009 08:05 pm

Just a word of advice on spinals/epidurals and PE. Make sure the person administering this to you has plenty of experience. You don't want a new doc or someone in training. I say this from experience because the swelling in my back was so bad(as is common with PE), they tried for 15 minutes to place it(10 sticks, ouch!). If they had not been successful on the last one, it would have been General for me. My blood pressure was 178/110 when they finally decided to take me to surgery.
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Re : Preeclampsia and anaesthesia

Postby missgamecock » Thu Apr 09, 2009 09:59 pm

by missgamecock (6064 Posts), Thu Apr 09, 2009 09:59 pm

yep I got stuck 5 times with Cate and 5 times with Sara because of the swelling. I didn't realize I had that much swelling till the anesthesiolgist said that it took so many tries because of swelling in my back. Once I had that epidural in with Cate, my bp dropped from 160s/110s to 100/60 (it hasn't been that low in forever!!!). It stayed that way till the epidural wore off. Then it went up high again.
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Re : Preeclampsia and anaesthesia

Postby carjashaner » Fri Apr 10, 2009 09:44 am

by carjashaner (199 Posts), Fri Apr 10, 2009 09:44 am

Only one stick for me thank goodness!!! But 5 or 10 sticks....**ouch**!!
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Re : Preeclampsia and anaesthesia

Postby dohertyab » Tue Apr 14, 2009 09:05 am

by dohertyab (236 Posts), Tue Apr 14, 2009 09:05 am

I was in a teaching hospital and had a really experienced anesthesiolgist and it still took him 4 sticks to get it in due to swelling. My husband complained that while I was hunched over having contractions and getting a needle stuck in my spine I hurt his ribs because I was digging my head into him.... yeah he got a lot of sympathy on that one. For my next pregnancy, 1 contraction, 1 stick, next contraction, then numb, ahhh and that wasn't with someone who had as much experience. So the swelling really does make a huge difference
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Re : Preeclampsia and anaesthesia

Postby saving_grace » Tue May 05, 2009 12:04 am

by saving_grace (143 Posts), Tue May 05, 2009 12:04 am

So should a mom with pre-e not attempt a pain med free birth? Is it safer to get the epidural? I attempted to go without the epi but did not make it through transition thanks to pit and cytotec both causing never ending contractions. The good thing though was that my baby was out less than 30 mins later and my legs and vajayjay weren't even numb yet. I was able to move around and go pee on a real potty. :0) The bad part was I was scared for DD immediately after getting the epidural because the nurse said that alot of times babies will "crash" because mom's BP drops so suddenly. She did great but I would have felt horrible if something had happened to her because of my desire for the pain med, kwim? I don't know which way to go this time.
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Re : Preeclampsia and anaesthesia

Postby caryn » Wed May 06, 2009 00:18 am

by caryn (10124 Posts), Wed May 06, 2009 00:18 am

A lot of docs will recommend an epidural because it will lower maternal pressures, which lowers risk of stroke.

I'd ask the neos and the peri about what effects it might have on the baby. It's my understanding that they worry about placental perfusion when they drop pressures with bp meds, but that when they place an epidural, they tend to expand plasma volume when they push the fluids, and so placental perfusion doesn't generally drop substantially, which means that the baby's still getting plenty of blood.
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