title: Management of preeclampsia when diagnosed between 34-37 weeks gestation: deliver now or deliberate until 37 weeks?
abstract: OBJECTIVE
  To evaluate maternal-newborn outcomes with immediate or expectantly managed preeclampsia first diagnosed at 34-37 weeks.
  
  
  METHODS
  Late preterm patients with preeclampsia without severe features were randomly assigned to immediate delivery (n=94) or expectant management (n = 75) until 37 weeks gestation or earlier if severe features developed. Data were analyzed by appropriate tests for continuous or categorical outcomes with differences considered significant if p < 0.05.
  
  
  RESULTS
  The two groups were similar at presentation. 41% of those expectantly managed developed severe features of preeclampsia within 72 hours versus 3% in the immediately delivered group (p < 0.001). Immediate delivery did not significantly increase cesarean delivery or neonatal morbidity.
  
  
  CONCLUSIONS
  Immediate delivery of the late preterm patient with preeclampsia significantly lessens her development of severe features without significantly increasing newborn risks. For the expectantly managed late preterm patient with preeclampsia, close surveillance for the first 72 hours following diagnosis and twice weekly thereafter appears prudent.
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Owens
authors.forename: Brad
authors.initials: B
authors.lastname: Thigpen
authors.forename: Marc R
authors.initials: MR
authors.lastname: Parrish
authors.forename: Sharon D
authors.initials: SD
authors.lastname: Keiser
authors.forename: Sandip
authors.initials: S
authors.lastname: Sawardecker
authors.forename: Kedra
authors.initials: K
authors.lastname: Wallace
authors.forename: James N
authors.initials: JN
authors.lastname: Martin
mesh_terms: D000328:Adult; D000465:Algorithms; D002585:Cesarean Section / Q000379:methods; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods; D008922:Mississippi; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012307:Risk Factors