Perinatal outcomes in severe preeclampsia with peritoneal ascites - a single tertiary center experience

This study aimed to evaluate maternal and neonatal outcomes of women with severe preeclampsia (PE) with and without peritoneal ascites.

In this retrospective cohort study, 76 pregnant women diagnosed with severe PE between January 2019 and January 2024 were evaluated, including 23 with peritoneal ascites and 53 without. Maternal demographic, clinical, and laboratory parameters including neonatal outcomes were compared between the two groups.

Women with severe PE and peritoneal ascites had higher rates of previous preeclampsia (30.4 vs. 7.5%; P = 0.009), visual symptoms (52.2 vs. 22.6%; P = 0.011), and maternal blood transfusion (47.8 vs. 13.2%; P = 0.001). They also exhibited significantly higher urea levels and proteinuria (P < 0.05). In terms of neonatal outcomes, the ascites group delivered earlier (31.5 ± 3.9 vs. 33.8 ± 3.1 weeks; P = 0.008), had lower birth weights (median 1,400 g vs. 1,990 g; P = 0.015), and higher NICU admission (60.9 vs. 34.0%; P = 0.029) with longer NICU stays (P = 0.003). One case of HELLP syndrome was observed in the ascites group.

Presence of peritoneal ascites in severe PE is associated with worse maternal and neonatal outcomes, including increased transfusion requirement and adverse perinatal indicators. Detection of ascites may serve as an important clinical marker of disease severity, highlighting the need for closer surveillance and timely intervention.