What’s new in obstetric anesthesia? Focus on preeclampsia

• Preeclampsia-related morbidity/mortality is high; 60% of deaths may be avoidable.
• Many updated preeclampsia guidelines now promote faster diagnosis and management.
• Preeclampsia confers risk of vascular and metabolic disease intra- and postpartum.
• Severe hypertension is often under-reported and under-treated.
• For general anesthesia, adjuncts can blunt the hemodynamic response to intubation.

Recent advances in the diagnosis, pathogenesis, and understanding of preeclampsia-related morbidity provide opportunities to optimize clinical management of the mother and fetus. These discoveries are timely, as contemporary data suggest that the prevalence of preeclampsia, affecting 7.5% of pregnancies globally and 2–5% in the USA, has increased by up to 30% over the last decade. Managing pregnant patients with preeclampsia can be challenging for all members of the obstetric care team due to the disease’s multi-organ system maternal and fetal effects. This review presents recent updates in the definition of preeclampsia, etiology, comorbidities and therapeutic interventions and discusses how they impact the care of these high-risk patients.