title: Should we offer expectant management in cases of severe preterm preeclampsia with fetal growth restriction?
abstract: OBJECTIVE
  The purpose of this study was to assess maternal and fetal morbidity and death in cases of severe preterm preeclampsia that were managed expectantly.
  
  
  METHODS
  It is a retrospective study that included 155 singleton pregnancies with severe preeclampsia at <34 weeks of gestation that were managed expectantly over a 10-year period. Perinatal outcomes of both mother and fetus were stratified according to gestational age and the severity of fetal growth restriction < or =3th percentile, 4th to 5th percentile, >5th to10th percentile, and >10th percentile.
  
  
  RESULTS
  The mean gestational age at admission was 30.2 +/- 2.4 weeks (range, 23.9-34.0 weeks). The mean latency period was 5.3 +/- 5.2 days, with a perinatal mortality rate of 3.9%. Gestational age of <30 weeks of gestation was the strongest variable that affected perinatal outcome, whereas fetal growth restriction played a marginal role.
  
  
  CONCLUSIONS
  Expectant management is recommended strongly in fetuses at <30 weeks of gestation, irrespective of fetal growth restriction. Delivery should be considered at >30 weeks of gestation.
authors.affiliation: Department of Obstetrics and Gynecology, Maternal Fetal Medicine Division, Sainte-Justine Hospital, Montreal, Quebec, Canada.
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Shear
authors.forename: Denyse
authors.initials: D
authors.lastname: Rinfret
authors.forename: Line
authors.initials: L
authors.lastname: Leduc
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008428:Maternal Mortality / Q000639:trends*; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014463:Ultrasonography