[Severe maternal complications associated with pre-eclampsia: an almost forgotten pathology?]

Pre-eclampsia is a pregnancy-specific hypertensive syndrome associated with significant morbidity and mortality in mother and baby. With the increasing understanding of the disease process, the number of complications, and the maternal and perinatal deaths have fallen over the last few decades in the developed countries. In other parts of the world, the rates of mortality and morbidity remain high. We present eight cases of pre-eclamptic women with severe complications (eclampsia, HELLP syndrome, acute pulmonary edema, acute renal failure...) that were treated at our hospital in only a year, when we had not seen these pathologies in the last nine years. There was fetal death in three of the cases, related to abruptio placentae. There were no maternal deaths, but four mothers needed to be transferred to the intensive care unit, and required life-support techniques. The causes of these new events remain unclear. Can they be due to increase in maternal age or to the high incidence of abruptio placentae? Or maybe can they occur only by chance? These women with pre-eclampsia and severe complications that can have potentially devastating consequences are not an easily identified group. We concluded that women with pregnancy hypertension must be carefully managed by expert physicians, particularly if they are more than 30-35 years old, overweight, with previous history of hypertension or nulliparous, in order to decrease these several complications.