POSTPARTUM TUBAL-LIGATION AFTER PREGNANCY COMPLICATED BY PREECLAMPSIAOR GESTATIONAL HYPERTENSION

Objective: To determine the anesthetic and surgical morbidity associat ed with postpartum tubal ligation after pregnancy complicated by pregn ancy-induced hypertension. Methods: Preoperative hemodynamic measureme nts, laboratory results, choice of anesthetic technique, intraoperativ e hemodynamic changes, and postoperative morbidity were compared in 53 women with pregnancy-induced hypertension (hypertensive group) and 53 controls who underwent postpartum tubal ligation between October 1992 and November 1995. We used a retrospective case-control design. Resul ts: Preoperative mean blood pressure (BP) measurements (a standard dev iation) were greater in hypertensive women than in controls (158 +/- 2 2/91 +/- 12 versus 126 +/- 13/71 +/- 10 mmHg; P <.001). Among women gi ven spinal anesthetics for tubal ligation, the minimum intraoperative systolic BP was significantly lower in controls than in hypertensive w omen (P <.05). However, the maximum percentage decrease in systolic BP was greater in hypertensive women than in controls (33 +/- 14 versus 22 +/- 10%; P <.05). Only one patient in each group developed intraope rative hypertension. The percentage of patients discharged later than the first postoperative day was greater in hypertensive women than in controls (23 versus 8%; P <.05). Conclusion: The lack of profound hemo dynamic responses during spinal or general anesthesia for postpartum t ubal ligation supports the continued use of this procedure in selected women with pregnancy-induced hypertension.