title: Is expectant management of early-onset severe preeclampsia worthwhile in low-resource settings?
abstract: OBJECTIVE
  To evaluate the maternal and perinatal outcome following expectant management of early-onset severe preeclampsia (PE) at a tertiary hospital in Mansoura, Egypt.
  
  
  METHODS
  This prospective, observational study included 211 patients with severe PE, occurring between 24 and 34 weeks of gestation. They were classified according to gestational age on admission into three groups. Group 1 included 61 patients with gestational ages between 24 and 28 weeks. Group 2 (28 to <32 weeks) included 66 patients and group 3 (32-34 weeks) included 84 patients. Outcome measures included prolongation of gestation, and maternal and perinatal complications.
  
  
  RESULTS
  The median overall prolongation of gestation was 12 +/- 6 days. The rate of neonatal survival significantly increased (P < 0.001) from 12/61 (19.7%) in group 1 to 30/66 (45.5%) in group 2 and 67/84 (79.8%) in group 3. There were no maternal mortalities; however, 43 (20.4%) women developed significant morbidities. HELLP syndrome, renal impairment and placental abruption were the main complications.
  
  
  CONCLUSIONS
  In low-resource settings, expectant management of early-onset severe PE is associated with relatively higher rates of perinatal mortality and maternal morbidity and should be limited to gestational ages between 28 and 34 weeks of gestation.
authors.affiliation: Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt.
authors.forename: El-Said
authors.initials: el-S
authors.lastname: Abdel-Hady
authors.forename: Muhammad
authors.initials: M
authors.lastname: Fawzy
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Negeri
authors.forename: Mohamed
authors.initials: M
authors.lastname: Nezar
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ragab
authors.forename: Adel Saad
authors.initials: AS
authors.lastname: Helal
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004534:Egypt; D005260:Female; D005313:Fetal Death; D005323:Fetal Monitoring / Q000379:methods; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage; D006784:Hospitals, Teaching; D006801:Humans; D007231:Infant, Newborn; D007741:Labetalol / Q000008:administration & dosage; D007902:Length of Stay; D008750:Methyldopa / Q000008:administration & dosage; D011225:Pre-Eclampsia / Q000517:prevention & control / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D005938:Glucocorticoids; D008750:Methyldopa; D007741:Labetalol