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

We hypothesised that long term epidural anaesthesia suppresses sympathetic overactivity in pre-eclampsia. Two equal groups of severe pre-eclamptic pat ients were treated either with long-term epidural anaesthesia (epidural gro up) 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 protein uria decreased in four cases. All patients treated with a long-term epidura l therapy continued their pregnancies for more than 3 weeks after admission . The infants in the epidural group had I-min Apgar scores above 8, a body weight of 2240 +/- 310 g (mean +/- s.d.) and normal neonatal progress. In c ontrast, the pregnancies of eight patients in the control group were termin ated within 2 weeks of admission due to severe pre-eclampsia or foetal dist ress, the birth weight of the infants was 1590 +/- 380 g (mean +/- s.d.) an d four had neonatal distress. Progressive worsening in the mean arterial pr essure, proteinuria, platelet count and serum total protein was found in th ese patients. Long-term epidural anaesthesia suppresses the sympathetic hyp eractivity and thus improves pre-eclamptic condition which may open a new t reatment in case of progressive severe preeclampsia.