Abstract

Pre-eclampsia or eclampsia is a cause of maternal morbidity and mortality. It is characterized by the triad of maternal hypertension, proteinuria and generalized edema. The etiology of pre-eclampsia or eclampsia is thought to be a decreased placental perfusion which results in an increased production of renin, angiotensin, aldosteron, thrombolplastin and a decreased production of prostaglandin. Anesthesiologists have to perform anesthesia technic for high-risk toxemia of pregnancy, and make proper choices of anesthesia method and drugs. Advantages of generaI anesthesia for Cesarian-section in cases of eclampsia include rapid induction, less hypotension, control of venti1ation and fetal oxygenation. Disadvantages include myocardial depression from the anesthetic drugs, hypertension during light anesthesia, the interaction between magnesium sulfate and muscle relaxants which might lead to prolonged respiratory paralysis and neonatal depression associated with the general anesthesia. The author used general anesthesia for the Cesarian-section in two severe toxemic patients who had pulmonary edema and bloody sputum because of congestive heartfailure. One patient had cardiac arrest upon arrival at the emergency room and after cardiopulmonary resuscitation the Cesarian-section was performed. The mother had complete recovery, but the baby expired in twenty-ninehours, The Motber and twin babies in the other case had complete recovery.