[Obstetric behavior based on evidences. Mild preeclampsia: expectant management, inpatient or outpatient?]

Preeclampsia is a multifactorial disease of unknown ethiology and definitive treatment is delivery. Before, the tendency was to avoid maternal complications, for what the pregnancy was interrupted without caring the fetal conditions. For some decades, the expectant handling has been preferred with the purpose of prolonging the pregnancy so that it matures the fetus and diminish the consequences on the perinatal morbility and mortality. There are divergent opinions on carrying out it in an ambulatory or hospital way. Here these two behaviors are revised with base in the medical discoveries. Initially, the hospital handling was based more in the clinical experience (observational evidence) that in controlled and aleatory studies. Three studies are shown carried out in the United States. In three controlled and randomized tests published in the United Kingdom this behavior was objected and it was intended the monitored ambulatory handling. In other two controlled and randomized trials and in two comparative trials, made also in the United Kingdom, it was suggested that the handling should be carried out in the units of care and fetal surveillance. In four observational studies it was intended the ambulatory handling, and the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy and American College of Obstetricians and Gynecologist considered it an option in selected women. The current proposal is summarized for the ambulatory handling of women with early mild preeclampsia.