Date of Award

Spring 2024

Document Type

DNP Project

Project Team Faculty Member

Whitney Heischmidt


Anesthesia, anesthesia management, preeclamptic parturient, preeclampsia


Preeclampsia is a placental disease characterized by abnormal maternoplacental blood vessels and placental dysfunction resulting in fetoplacental hypoperfusion and maternal multi-system organ dysfunction (Wang et al., 2019). Expectant management of a hypertensive or preeclamptic parturient includes antihypertensive medications, magnesium sulfate for seizure prophylaxis, and early delivery of the fetus (ACOG, 2020). Neuraxial anesthetic-induced sympathectomy combined with circulating antihypertensives, magnesium sulfate therapy, and intravascular volume depletion in preeclampsia is thought to contribute to exaggerated hypotension.

Persistent refractory hypotension after neuraxial anesthesia in parturients with preeclampsia or hypertension has been an ongoing issue affecting obstetric providers at the host facility. This project involved the creation of a communication tool to promote early consultation with the anesthesia team in the care of the preeclamptic parturient. Early anesthesia involvement can facilitate improved patient outcomes by providing early epidural analgesia, co-loading IV fluids, and appropriate timing or holding of antihypertensives. An educational PowerPoint presentation and communication tool were presented to the anesthesia providers at the host facility, followed by a short survey. The survey results were positive and indicated the communication tool was user-friendly and effective for improved communication. This project promotes best practice in caring for the hypertensive or preeclamptic parturient.

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