ANESTHETIC MANAGEMENT IN CAESAREANS ASSOCIATED WITH HYPERTENSIVE CRISES: An integrative literature review

Abstract

Pregnancy promotes several physiological adaptations in the maternal body that, when combined with the changes caused by Hypertensive Disorders of Pregnancy (HDP), significantly increase maternal and fetal risks. This scenario requires special attention, especially in obstetric emergencies where the choice of anesthetic technique is crucial for maternal and fetal safety. This study aims to evaluate the main anesthetic interventions in emergency cesarean sections among women with hypertensive syndromes. It is an integrative literature review based on articles published between 2020 and 2025 in PubMed, ScienceDirect, SciELO, and LILACS databases. The DeCS descriptors “Pré-eclâmpsia”, “Eclâmpsia”, and “Anestesia” and the MeSH terms “Hypertension, Pregnancy-Induced”, “Anesthesia”, and “Cesarean Section” were used, combined with the Boolean operators “AND” and “OR”. Studies in Portuguese, English, and Spanish, freely available in full text and addressing anesthetic management in hypertensive patients undergoing emergency cesarean section, were included, totaling 10 articles. The research analyzed spinal, epidural, and general anesthesia techniques, assessing their effects on hemodynamic stability, pain control, postoperative recovery, and neonatal outcomes. The heterogeneity of findings highlights the need for individualized anesthetic management according to maternal clinical conditions. It is concluded that proper anesthetic management in emergency cesarean sections due to HDP is essential for maternal and fetal safety. Evidence-based decisions and multidisciplinary collaboration are crucial to ensure safer, more effective, and humanized obstetric care.