Planned delivery or expectant management for late preterm pre-eclampsia: study protocol for a randomised controlled...

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Trials

Background:

• Pre-eclampsia is a serious pregnancy disorder characterized by hypertension and multisystem complications.
• Adverse outcomes include severe maternal morbidity and mortality, as well as fetal growth restriction and death.
• The optimal timing for delivery in pre-eclampsia between 34 and 37 weeks gestation remains unclear.

Purpose of the Study:

• To determine if planned early delivery reduces adverse maternal outcomes in pre-eclampsia between 34 and 37 weeks gestation.
• To assess if planned early delivery increases short-term harm to infants (perinatal deaths or neonatal unit admissions).
• To evaluate the impact of planned early delivery on long-term infant neurodevelopmental status at 2 years corrected age.

Main Methods:

• The PHOENIX trial is a non-masked, randomized controlled trial.
• It compares planned early delivery (within 48 hours of randomization) with usual care (expectant management).
• Participants are women with pre-eclampsia between 34 and 37 weeks gestation.

Main Results:

• Results are pending as the trial is ongoing.
• The study aims to provide evidence to guide clinical practice.
• This research addresses a critical gap in managing pre-eclampsia in this gestational window.

Conclusions:

• Current UK practice for pre-eclampsia management varies by gestation.
• Previous trials have not definitively answered the question of optimal delivery timing between 34 and 37 weeks.
• The PHOENIX trial results are expected to influence international clinical practice and guidelines.