title: Benefits and risks of expectant management of severe preeclampsia at less than 26 weeks gestation: the impact of gestational age and severe fetal growth restriction.
abstract: OBJECTIVE
  To determine maternal and perinatal outcome in women with severe preeclampsia at <26 weeks according to gestational age at the onset of expectant management and the presence of severe fetal growth restriction (<5th percentile).
  
  
  METHODS
  Fifty-one patients (53 fetuses; 2 twins) were retrospectively studied.
  
  
  RESULTS
  Median prolongation was 7 days (2-55). Maternal morbidity rate was 43%. Perinatal survival rate was 42%. Severe fetal growth restriction complicated 17 fetuses (33%). There were no perinatal survivors in those managed at <24 weeks (n = 12). For those at 24-24(6/7) and 25-25(6/7) weeks, the perinatal survival rates were 50% and 57%, respectively, and in the presence of severe fetal growth restriction 0% and 30%, respectively.
  
  
  CONCLUSIONS
  Perinatal outcome in severe preeclampsia in the midtrimester is dependent on gestational age and/or the presence of severe fetal growth restriction. Given the high maternal morbidity and the extremely low perinatal survival rates, we do not recommend expectant management before 24 weeks and/or in those with severe fetal growth restriction at any gestational age <26 weeks.
authors: Department of Obstetrics and Gynecology, University Paris 12, Creteil, France.
authors: Jérémi
authors: J
authors: Belghiti
authors: Gilles
authors: G
authors: Kayem
authors: Vassili
authors: V
authors: Tsatsaris
authors: François
authors: F
authors: Goffinet
authors: Baha M
authors: BM
authors: Sibai
authors: Bassam
authors: B
authors: Haddad
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies