4.6 Article

Should we offer expectant management in cases of severe preterm preeclampsia with fetal growth restriction?

Journal

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 192, Issue 4, Pages 1119-1125

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2004.10.621

Keywords

preterm preeclampsia; fetal growth restriction; indication for delivery; expectant management

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Objective: The purpose of this study was to assess maternal and fetal morbidity and death in cases of severe preterm preeclampsia that were managed expectantly. Study design: It is a retrospective Study that included 155 singleton pregnancies with severe precclatupsia at < 34 weeks of gestation that were managed expectantly over a 10-year period. Perinatal outcomes of both mother and fetus were stratified according to gestational age and the severity of fetal growth restriction <= 3th percentile, 4th to 5th percentile, > 5th to 10th percentile, and > 10th percentile. Results: The mean gestational age at admission was 30.2 +/- 2.4 weeks (range, 23.9-34.0 weeks). The mean latency period was 5.3 +/- 5.2 days, with a perinatal mortality rate of 3.9%. Gestational age of < 30 weeks of gestation was the strongest variable that affected perinatal outcome, whereas fetal growth restriction played a marginal role. Conclusion: Expectant management is recommended strongly in fetuses at < 30 weeks of gestation, irrespective of fetal growth restriction. Delivery should be considered at > 30 weeks of gestation. (c) 2005 Elsevier Inc. All rights reserved.

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