Treatment of severe preeclampsia remote from term: a clinical dilemma.
Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Women with severe preeclampsia are usually delivered without delay. In recent years, a new approach in the treatment of women with severe preeclampsia remote from term has been advocated by several investigators worldwide. This approach advocates conservative management in a selected group of women with severe preeclampsia remote from term with the aim of improving perinatal outcome without compromising maternal safety. In most studies, patients who were candidates for conservative management had a blood pressure of more than 160/110, whereas in some studies, women with heavy proteinuria were also considered suitable. Only very few studies have supported conservative management in patients with signs and symptoms of HELLP syndrome. It is imperative to carefully balance maternal and fetal risks before choosing conservative management in severe preeclampsia remote from term.


BACKGROUND
Obstetricians & Gynecologists, Family Physicians.


OBJECTIVE
After completion of this article, the reader will be able to understand which patients are most likely to benefit from conservative management of severe preeclampsia remote from term, what the conservative management of severe preeclampsia remote from term entails, and what are the benefits of conservative management of preeclampsia remote form term.
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Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv, Israel. arielm@shani.net
Kuperminc
M J
MJ
Pausner
D
D
Lessing
J B
JB
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D017359:HELLP Syndrome / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008428:Maternal Mortality; D010347:Patient Care Planning; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D018570:Risk Assessment; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones; D000959:Antihypertensive Agents