EPIDURAL ANALGESIA DURING LABOUR IN PATIENTS WITH PRE-ECLAMPSIA

Summary

Epidural analgesia was given during labour to 150 women with pre-eclampsia. All had proteinuria and a blood pressure of at least 160/100 mm. Hg before treatment. Blood pressures were reduced by over 20 per cent on average, although 5 per cent of patients did not have a fall in blood pressure. Four patients had an eclamptic fit, but only after the epidural block had worn off and in the absence of an anticonvulsant drug. There were no maternal deaths and no maternal morbidity attributable to the treatment. There were three stillbirths and three neonatal deaths due mainly to prematurity and placental insufficiency (perinatal mortality 3·9 percent). The Caesarean section rate was 6·6 per cent. Epidural analgesia provides pain relief and usually a valuable reduction in blood pressure for the pre-eclamptic patient in labour. Combined with an anticonvulsant (usually chlormethiazole in this series) it provides balanced therapy and avoids the use of narcotics in excessive doses.