Anesthesia Considerations 

Definitions: Hypertensive Disorders of Pregnancy (HDP)

• HTN in pregnancy: SBP ≥140 mmHg and/or DBP ≥90 mmHg (avg of ≥2 measurements @ least 15 mins apart in same arm)

• Resistant HTN: need for 3 antihypertensives for BP control @ ≥20 wks gest

• Severe HTN: SBP ≥160 mmHg or DBP ≥110 mmHg

• Significant proteinuria: ≥0.3 g/d (24 hr collection) or ≥20 mg/mmol (random urine)

  • Suspect if dipstick ≥1+ protein

• HELLP syndrome

  • Hemolysis

  • Elevated Liver enzymes

  • Low Platelets

• Adverse condition: increases risk of severe complications (see table)

• Serious complication: warrants delivery (see table)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reference: Magee, Laura A et al. “Guideline No. 426: Hypertensive Disorders of Pregnancy: Diagnosis, Prediction, Prevention, and Management.” Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC vol. 44,5 (2022): 547-571.e1. doi:10.1016/j.jogc.2022.03.002