Document Detail


Expectant versus aggressive management in severe preeclampsia remote from term.
MedLine Citation:
PMID:  18830544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Our study aims to compare neonatal and maternal outcomes between expectant (or conservative) and aggressive (or immediate) management in cases with severe preclampsia remote from term. METHODS: This is a comparative study conducted at Al-Batool Teaching Hospital in Mosul City, Iraq, from April 2003 to August 2004. A total of 74 singleton pregnancies complicated by severe preeclampsia with gestational age of 24-34 weeks were studied during this period. The criteria used for the diagnosis of severe preeclampsia were in accordance with the guidelines of the American College of Obstetricians and Gynaecologists. All the patients were counselled for expectant management. 39 patients were delivered immediately due to refusal of expectant management either by the patient or the attending physician. The other 35 patients were managed expectantly; this group was followed-up and carefully monitored for a period ranging from 72 hours to 18 days. Neonatal parameters, neonatal outcome and maternal outcome were compared between the two groups. RESULTS: The mean value of pregnancy prolongation was 9.2 days. Median gestational age for the first group was 29 weeks, and for the second group, it was 30 weeks. Regarding neonatal parameters, the expectantly-managed group had a higher Apgar score at one minute (3.56 +/- 1.72 vs. 5.05 +/- 1.77, p-value equals 0.001), lower mean days of hospitalisation in the neonatal intensive care unit (6.83 +/- 5.38 vs. 4.50 +/- 3.46, p-value equals 0.03), with a lower incidence of neonatal and maternal complications. CONCLUSION: Expectant management is recommended in patients with severe preeclampsia remote from term, after proper selection of patients and careful monitoring.
Authors:
D S Sarsam; M Shamden; R Al Wazan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Singapore medical journal     Volume:  49     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-02     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  698-703     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Al-Kindy Medical College, Baghdad University, Baghdad, Iraq. samarsarsam4@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Delivery, Obstetric
Female
Gestational Age
HELLP Syndrome / drug therapy
Humans
Infant, Newborn
Iraq
Neonatal Screening
Obstetrics / methods*
Pre-Eclampsia / diagnosis*,  drug therapy*
Pregnancy
Pregnancy Complications, Cardiovascular / diagnosis,  drug therapy
Pregnancy Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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