[Conservative management in severe pre-eclampsia].

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Severe preeclampsia poses significant risks to both mother and fetus.
• Timely delivery is often indicated, but the optimal timing for severe preeclampsia diagnosed between 28-33 weeks is debated.

Purpose of the Study:

• To compare outcomes of expectant management versus early delivery in women with severe preeclampsia between 28-33 weeks of gestation.

Main Methods:

• A cohort of 58 women with severe preeclampsia (28-33 weeks gestation) was studied.
• Patients were divided into two groups: early delivery (within 48 hours) and expectant management.
• Outcomes assessed included maternal complications, fetal compromise, stillbirths, and neonatal deaths.

Main Results:

• 34 patients (58%) received expectant management, achieving an average pregnancy prolongation of 6.4 days.
• Indications for delivery in the expectant group included maternal complications (47%), fetal compromise (39%), and preterm labor.
• The expectant management group had no maternal complications or fetal deaths; one neonatal death occurred due to sepsis and prematurity.
• The early delivery group (24 women) experienced two stillbirths and three neonatal deaths.

Conclusions:

• Expectant management of severe preeclampsia between 28-33 weeks gestation appears safe, with no associated maternal or fetal mortality in this study.
• Expectant management can prolong gestation, potentially improving neonatal outcomes.
• Early delivery in this gestational window was associated with higher rates of adverse perinatal outcomes.