title: Induction or caesarean section for preterm pre-eclampsia?
abstract: Controversy continues over the mode of delivery in severe pre-eclampsia remote from term. The aim of this study was to assess prospectively the mode of delivery in severe pre-eclampsia remote from term. The clinical data of 108 women who presented consecutively with severe pre-eclampsia over a 1-year period was used for the study material. Sixty-eight (63%) patients were delivered by elective caesarean section and 40 (37%) underwent induction of labour. Twenty-six had a vaginal delivery following induction, the others (n = 14) had emergency caesarean section. No baby with a gestational age of < or = 27 weeks survived after delivery. Perinatal mortality was highest for the babies delivered following induction of labour (vaginal delivery vs. caesarean section after induction of labour, P = 0.0004; vaginal delivery vs. elective caesarean section, P = 0.002). Severe pre-eclampsia remote from term is associated with a high caesarean section rate. In this study, carried out in a developing country, elective caesarean section contributed to a better perinatal outcome than vaginal delivery or emergency caesarean section following induction of labour.
authors.affiliation: MRC/UN Pregnancy Hypertension Research Unit and Department of Obstetrics and Gynaecology, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.
authors.forename: C D
authors.initials: CD
authors.lastname: Mashiloane
authors.forename: J
authors.initials: J
authors.lastname: Moodley
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000706:statistics & numerical data*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012720:Severity of Illness Index; D013019:South Africa / Q000453:epidemiology