title: Expectant management of preterm preeclampsia in Indonesia and the role of steroids.
abstract: OBJECTIVE
  To present the outcome of expectant management of preterm preeclampsia in Indonesia, and the effect of ongoing treatment with methylprednisolone (MP) on maternal and perinatal outcome.
  
  
  METHODS
  Prospective RCT on 48 patients with early-onset preeclampsia. Following the administration of dexamethasone for fetal lung maturation, patients were randomized to receive 25 mg MP group IV for the first week, decreasing to 12.5 mg during 2nd week and continued till birth, or matching IV placebo treatment (PL group). Prolongation of entry to delivery interval served as primary outcome measurement.
  
  
  RESULTS
  The average time gained with expectant management was almost 14 days. However, there was no difference of mean time interval between entry to delivery between the PL (13.8 days) and MP (13.7 days) groups. Antenatal ongoing treatment with IV MP also did not improve maternal and/or perinatal outcome and might be associated with a higher risk for severe maternal infections--in particular tuberculosis.
  
  
  CONCLUSIONS
  Expectant management of preterm preeclampsia is a realistic option in a major Indonesian perinatal referral center. Steroids (outside the use for fetal lung maturation) should not be used in the expectant management of preterm preeclampsia in Indonesia.
authors.affiliation: a Department of Obstetric Gynecology , Medical Faculty Airlangga University , Surabaya , Indonesia .
authors.lastname: Ernawati
authors.affiliation: a Department of Obstetric Gynecology , Medical Faculty Airlangga University , Surabaya , Indonesia .
authors.forename: Erry
authors.initials: E
authors.lastname: Gumilar
authors.affiliation: b Department of Statistic , Public Health Faculty Airlangga University , Surabaya , Indonesia .
authors.lastname: Kuntoro
authors.affiliation: c Department of Internal Medicine , Medical Faculty Airlangga University , Surabaya , Indonesia , and.
authors.forename: Joewono
authors.initials: J
authors.lastname: Soeroso
authors.affiliation: a Department of Obstetric Gynecology , Medical Faculty Airlangga University , Surabaya , Indonesia .|d Women's and Children's Division, Lyell McEwin Health Service, Medical School North , University of Adelaide , Elizabeth Vale , Australia.
authors.forename: Gus
authors.initials: G
authors.lastname: Dekker
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000517:prevention & control; D008775:Methylprednisolone / Q000627:therapeutic use*; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies; D057832:Watchful Waiting; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: Expectant management; preterm preeclampsia; steroids