Hypertensive disorder of pregnancy (HDCP) is associated with increased inflammatory activation and hemodynamic instability, which may adversely affect maternal and neonatal outcomes during delivery. A study published in the Gynecologic and Obstetric Investigation evaluated the impact of epidural anesthesia on serum inflammatory markers and hemodynamic parameters in women with HDCP undergoing childbirth.

A total of 100 pregnant women diagnosed with HDCP and admitted between June 2021 and December 2023 were included. Participants were allocated into two groups: a control group undergoing conventional vaginal delivery without analgesia and a painless group receiving continuous epidural anesthesia, with 50 patients in each group. 

Serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), along with hemodynamic parameters including heart rate (HR), mean arterial pressure (MAP), and cardiac output (CO), were measured at predefined time points: before analgesia (T1), at full cervical dilation (T2), at fetal delivery (T3), and 24 hours postpartum (T4). Maternal labor characteristics and neonatal outcomes were also assessed.

Compared with the control group, the epidural anesthesia group demonstrated shorter durations of the first, second, and third stages of labor, along with earlier colostrum secretion and higher 1-minute Apgar scores (P < 0.05). Levels of TNF-α and IL-6 at T2, T3, and T4 were significantly lower in the epidural group (P < 0.05). Additionally, fluctuations in MAP, HR, and CO across T2 to T4 were reduced, indicating greater hemodynamic stability.

Epidural anesthesia was associated with reduced inflammatory response and improved hemodynamic stability in HDCP. These findings highlight measurable differences in maternal and neonatal outcomes with epidural use.