Mortality and morbidity associated with early-onset preeclampsia.
OBJECTIVE
To examine the management of early-onset preeclampsia and its maternal and fetal morbidity and mortality.


METHODS
Retrospective cohort study of 49,812 births at a university teaching hospital between June 1986 and March 1997. Seventy-one women were identified with a diagnosis of preeclampsia with an onset at less than 30 completed weeks of gestation.


RESULTS
The incidence of very preterm preeclampsia was 1 in 682 total births. The mean diagnosis to delivery interval (range) was 14 days (0-49 days). There were no maternal deaths. Fifteen women (21%) had developed HELLP/ELLP syndrome, 9 (13%) had renal failure, 1 (1.4%) had eclampsia, and 11 (15%) had an abruption. Five women (7%) had a termination of pregnancy, 57 (80%) were delivered by cesarean section, and 4 (5%) required a classical incision. There were 12 intrauterine deaths (16%), 9 neonatal deaths (12%), and 52 neonatal survivors (72%). Two of the survivors were known to have neurological impairment at the 2-year follow-up.


CONCLUSIONS
A conservative approach to the management of early-onset preeclampsia results in a good obstetric outcome for the majority of fetuses, but this must be balanced against the significant risk of morbidity to the mothers.
Murphy
D J
DJ
St. Michael's Hospital, Southwell St., Bristol, United Kingdom.
Stirrat
G M
GM
D000328:Adult; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005323:Fetal Monitoring; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008428:Maternal Mortality; D011225:Pre-Eclampsia / Q000150:complications / Q000401:mortality / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D006113:United Kingdom / Q000453:epidemiology