Pregnancy outcome in women presenting with pre-eclampsia at less than 25 weeks gestation.
OBJECTIVE
We aimed to (i) assess maternal and perinatal outcomes in pre-eclampsia at < 25(0) weeks; and (ii) determine if any antenatal factors were associated with adverse maternal and perinatal outcomes.


METHODS
A retrospective study.


METHODS
Tertiary referral hospital, Auckland, New Zealand.


METHODS
Data were extracted from the clinical record and hospital database. The study population involved women admitted with pre-eclampsia at < 25(0) weeks, with a live singleton pregnancy, from 1997 to 2004 and managed expectantly.


METHODS
Maternal morbidity, perinatal death, neurodevelopmental outcome at 18 months, small for gestational age assessed by population and customised birthweight centiles.


RESULTS
Gestation at admission was the only antenatal variable associated with adverse perinatal outcome. Of 14 women admitted < 23 weeks, no babies survived, but eight (62%) babies of women admitted in the 24th week (24(0)-24(6)) survived. Neurodevelopmental outcome was assessed in eight of nine survivors; two (25%) had moderate and two (25%) had minor disability. All babies in this cohort had birthweights < 5th customised centile. Only one baby (10%) weighing < 500 g survived.


CONCLUSIONS
Maternal morbidity was high in this expectantly managed cohort. As no babies survived when pre-eclampsia occurred before 23 weeks, induction of labour should be considered. In the 24th week two-thirds of babies survived and 25% had moderate handicap. This information may help clinicians and women in the future to make informed choices about management.
Budden
Astrid
A
National Women's Health, Auckland City Hospital, Auckland, New Zealand.
Wilkinson
Lucille
L
Buksh
Mariam Jan
MJ
McCowan
Lesley
L
D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D008875:Middle Aged; D011225:Pre-Eclampsia; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal