Pregnancy prolongation following diagnosis of pre-eclampsia with severe features remote from term

Primarily, to describe duration of pregnancy prolongation after diagnosis with pre-eclampsia with severe features before 34 weeks of pregnancy. Secondary objectives were to describe (1) maternal and neonatal complications and (2) patients diagnosed with pre-eclampsia with severe features versus superimposed pre-eclampsia with severe features (SIPE).

This was a retrospective study of patients with singleton pregnancies diagnosed with pre-eclampsia with severe features or SIPE up to 33⁺⁴ weeks of pregnancy from January 1, 2015, through December 31, 2023, at a single tertiary urban hospital. Patient characteristics, duration of pregnancy prolongation, and outcomes were extracted from medical records. Bivariate analysis compared patients with pre-eclampsia with severe features and SIPE.

There were 153 patients identified of which 75 (49.0%) had chronic hypertension. Mean gestational age at diagnosis was 29.9 weeks. Median duration of pregnancy prolongation was 2 days and mean was 4.8 days. Maternal and neonatal complications occurred in 40 (26.1%) and 102 (66.7%) cases, respectively. Compared with patients without chronic hypertension, duration of pregnancy prolongation was longer among patients with SIPE (median 3 days vs. 2 days, P = 0.006; mean 6.3 days vs. 3.4 days, P = 0.018). However, outcomes were similar.

Pregnancy prolongation following a diagnosis of pre-eclampsia with severe features or SIPE before 34 weeks of pregnancy was typically less than 1 week. Maternal and neonatal complications were common.