Expectant management of severe pre-eclampsia in the mid-trimester.
OBJECTIVE
To determine maternal and perinatal outcomes with expectant management of severe pre-eclampsia in the mid-trimester, using a defined entry point.


METHODS
Prospective case series. Thirty-nine women admitted from 24 to 27 week's gestation with severe pre-eclampsia, whose pregnancies were otherwise stable, were managed expectantly with careful clinical and biochemical monitoring of maternal and foetal status, together with careful blood pressure control, in a high-care obstetric ward. The aim was to safely prolong the pregnancies and thereby improve perinatal outcome.


RESULTS
Gestation was prolonged by a median of 12 (range 3--47) days, with greater periods gained at earlier gestations. The overall perinatal loss was 26% and the neonatal loss 17%. The rates of significant maternal complications were low.


CONCLUSIONS
Expectant management of selected women with severe pre-eclampsia from 24 to 27 weeks' gestation in a tertiary care unit is acceptably safe and improves perinatal outcome.
Hall
D R
DR
Department of Obstetrics and Gynecology, MRC Perinatal Mortality Research Unit, Tygerberg Hospital and University of Stellenbosch, P.O. Box 19081, Tygerberg 7505, South Africa. drh@gerga.sun.ac.za
Odendaal
H J
HJ
Steyn
D W
DW
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications; D005323:Fetal Monitoring; D005865:Gestational Age; D017359:HELLP Syndrome / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000628:therapy; D007226:Infant Mortality; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies