Mortality and morbidity associated with early-onset preeclampsia

Area of Science:

• Obstetrics and Gynecology
• Perinatology
• Maternal-Fetal Medicine

Background:

• Early-onset preeclampsia, diagnosed before 30 weeks gestation, presents significant risks to both mother and fetus.
• Effective management strategies are crucial to optimize outcomes in these high-risk pregnancies.

Purpose of the Study:

• To evaluate the maternal and fetal morbidity and mortality associated with the management of early-onset preeclampsia.
• To assess the outcomes of a conservative management approach in cases of preterm preeclampsia.

Main Methods:

• Retrospective cohort study including 49,812 births.
• Identified 71 women diagnosed with preeclampsia before 30 completed weeks of gestation.
• Analyzed maternal and fetal outcomes, including complications and delivery methods.

Main Results:

• The incidence of very preterm preeclampsia was 1 in 682 births.
• No maternal deaths occurred; however, significant maternal morbidity included HELLP/ELLP syndrome (21%), renal failure (13%), and eclampsia (1.4%).
• Fetal outcomes included 16% intrauterine deaths, 12% neonatal deaths, and 72% neonatal survivors, with 2 survivors experiencing neurological impairment.

Conclusions:

• A conservative management strategy for early-onset preeclampsia can lead to favorable fetal outcomes for most infants.
• This approach must be carefully weighed against the substantial risks of maternal morbidity.
• Individualized management plans are essential to balance maternal safety and fetal well-being.