title: [Criteria for birth delivery in women with severe preeclampsia in expectant management].
abstract: BACKGROUND
  Preeclampsia complicates pregnancy in 3% to 8%, in Mexico it occurs in 5% to 10% of all pregnancies. The world incidence of the severe form all is unknown; however, in United States an incidence of 1% has been reported. Among the causes precipitating birth induction are intrauterine growth restriction, fetal distress and placenta abruption.
  
  
  OBJECTIVE
  To determine maternal and fetal complications in women with severe preeclampsia who were admitted to the National Institute of Perinatology, and to establish the indications for birth induction in these women undergoing expectant management between 25 to 32 weeks of gestation.
  
  
  METHODS
  A retrospective cohort study in which we reviewed the records of all patients diagnosed with severe preeclampsia between 2005 and 2009, and we used those records of women who had a diagnosis of severe preeclampsia at admission and who met criteria for expectant management, the data were collected in a database of art, and then analyzed the different variables in Statistical Package for the Social Sciences (SPSS).
  
  
  RESULTS
  Of the 27 patients studied, the average weeks of gestation on admission was 29.2, 41% were nulliparous as main risk factor, 100% completed lung maturity; the average time of days of expectant management was 3.1 +/- 1.3 days (interval: one to seven days). The average gestational age at the birth induction was of 30.1 weeks (interval: 25.2 to 32.5 weeks of gestation). The main criteria for birth induction were: hypertensive crisis (44%), intrauterine growth restriction (30%), hypertensive encephalopathy and epigastric pain (19% each), elevation of transaminases and thrombocytopenia (11%), and oliguria (7%). The way of birth was 96% by caesarean and 4% by vaginal birth.
  
  
  CONCLUSIONS
  The main criteria for birth induction in our sample were the uncontrolled blood pressure and intrauterine growth restriction. The time for the extension of the pregnancy was not significant compared with other studies; however, fetal lung maturity was completed.
authors.affiliation: Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, México, DF. r_castellon@hotmail.com
authors.forename: Rosa Marcela
authors.initials: RM
authors.lastname: Castellón Pasos
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Hernández Pacheco
authors.forename: Ariel
authors.initials: A
authors.lastname: Estrada Altamirano
authors.forename: Rogerio Armando
authors.initials: RA
authors.lastname: Chacón Solís
authors.forename: Mauricio
authors.initials: M
authors.lastname: Ríos Barba
mesh_terms: D000328:Adult; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D057832:Watchful Waiting