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Delivery of patients with early onset, severe pre-eclampsia
D R Hall1, H J Odendaal, D W Steyn
1Department of Obstetrics and Gynecology, Tygerberg Hospital and University of Stellenbosch, Tygerberg 7505, South Africa. drh@gerga.sun.ac.za
Objectives:
To compare the effects of induction/labor to delivery before labor in early onset, severe pre-eclampsia.
Methods:
Five-year prospective case series. Delivery course and neonatal outcome were examined for 335 women with viable singletons.
Results:
Induction was successful in 45% of attempts. Women exposed to labor had longer (5.5 days, P<0.0001) admissions to delivery periods and were more often delivered for maternal indications (RR=2.87, 95% CI=1.98-4.16). Their babies were born 1.6 weeks older (P<0.0001) and 352 g heavier (P<0.0001) than those delivered before labor. Babies exposed to labor needed intensive care less often (RR=0.4, 95% CI=0.27-0.58), had lower rates of severe hyaline membrane disease (RR=0.26, 95% CI=0.11-0.59) and sepsis (RR=0.56, 95% CI=0.33-0.93), and were discharged earlier (P<0.0001).
Conclusions:
Exposure to induction/labor in selected patients is not detrimental to neonatal outcome in early, severe pre-eclampsia.