A new treatment of severe pre-eclampsia by long-term epidural anaesthesia.

Abstract

We hypothesised that long term epidural anaesthesia suppresses sympathetic overactivity in pre-eclampsia. Two equal groups of severe pre-eclamptic patients were treated either with long-term epidural anaesthesia (epidural group) or bed rest, diet control, and an antihypertensive drug (control group). After 7 days of epidural block, mean arterial blood pressures decreased, platelet count and serum total protein increased in all cases while proteinuria decreased in four cases. All patients treated with a long-term epidural therapy continued their pregnancies for more than 3 weeks after admission. The infants in the epidural group had 1-min Apgar scores above 8, a body weight of 2240+/-310 g (mean +/- s.d.) and normal neonatal progress. In contrast, the pregnancies of eight patients in the control group were terminated within 2 weeks of admission due to severe pre-eclampsia or foetal distress, the birth weight of the infants was 1590+/-380 g (mean +/- s.d.) and four had neonatal distress. Progressive worsening in the mean arterial pressure, proteinuria, platelet count and serum total protein was found in these patients. Long-term epidural anaesthesia suppresses the sympathetic hyperactivity and thus improves pre-eclamptic condition which may open a new treatment in case of progressive severe pre-eclampsia.