Document Detail

Expectant management of severe preeclampsia presenting before 25 weeks of gestation.
MedLine Citation:
PMID:  17968301     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The treatment of preeclampsia before 25 weeks of gestation remains controversial. The aim was to evaluate the outcome of expectant management of preeclamptic women presenting prior to 25 weeks of gestation. MATERIAL/METHODS: During a five-year period, 55 women presenting with severe preeclampsia at or before 24 weeks and 6 days of gestation were admitted to a high-care unit for expectant management. Indications for delivery were the development of severe maternal morbidity secondary to preeclampsia. Complications were identified from individual patient and infant records. RESULTS: Mean prolongation of gestation was 4.8+/-4.1 days (range: 1-13 days) and the mean maternal hospitalization period was 10.0+/-8.3 days (range: 2-31 days). Conservative management was associated with a 94.5% (52/55) intrauterine fetal loss rate. Of the three live-born infants, one died secondary to respiratory distress syndrome followed by neonatal sepsis and the other two survived with cognitive and motor developmental delay. HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome was diagnosed in 12 women (21.8%). Nine women (16.3%) required transfusions with blood or blood products. There was 1 case (1.8%) of eclampsia. Overall, 15 women (27.2%) had developed some maternal morbidity without any significant differences between <23 weeks' and >/=23 weeks' gestation. Nulliparity was not associated with stillbirth (p=0.8), HELLP syndrome (p=0.8), or overall maternal morbidity (p=0.7). None of the women died or required any long-term treatment. CONCLUSIONS: Conservative management of severe preeclampsia before 25 weeks of gestation is associated with considerable perinatal mortality and morbidity. Maternal complications are relatively common, but generally short-lived.
Mekin Sezik; Okan Ozkaya; Hulya Toyran Sezik; Elif Gul Yapar
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  13     ISSN:  1234-1010     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-30     Completed Date:  2008-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  CR523-527     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Suleyman Demirel University School of Medicine, Isparta, Turkey.
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MeSH Terms
Eclampsia / therapy
Fetal Death
Gestational Age
HELLP Syndrome / therapy
Infant, Newborn
Pre-Eclampsia / therapy*
Pregnancy Outcome

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