Clinical Characteristics, Management, and Perinatal Outcomes of Third-Trimester Preeclampsia at a Tertiary Hospital...

To describe the clinical and laboratory characteristics of third-trimester preeclampsia, summarize management patterns, and identify factors associated with adverse neonatal outcomes at a single public tertiary referral obstetrics and gynecology hospital in Vietnam.

This retrospective descriptive study included 154 pregnant women diagnosed with preeclampsia and delivered at a single public tertiary referral obstetrics and gynecology hospital in Vietnam between August 1, 2022 and July 31, 2023. Clinical, laboratory, treatment, delivery, and neonatal data were analyzed using descriptive statistics and logistic regression. The composite adverse neonatal outcome was defined as the presence of one or more of the following: fetal growth restriction, preterm birth, intrauterine fetal death, low birth weight, neonatal respiratory morbidity, neonatal transfer, or perinatal death.

Severe preeclampsia accounted for 57.1% of cases. Maternal age ≥35 years was associated with severe disease (OR 3.00, 95% CI 1.56-5.85), as were primigravidity (OR 1.98, 95% CI 1.03-3.78), prior stillbirth (OR 2.94, 95% CI 1.10-7.80), and assisted conception in the index pregnancy (OR 3.35, 95% CI 1.20-9.36). Elevated liver enzymes, hypoalbuminemia, hyperuricemia, and elevated urea were more frequent in severe preeclampsia. All women with severe preeclampsia underwent cesarean delivery; the overall cesarean rate was 81.2%. Preterm birth occurred in 35.7% of pregnancies and fetal growth restriction in 10.4%. In multivariable analysis, adverse neonatal outcomes were associated with maternal age >35 years (adjusted OR 2.24), gestational age <34 weeks (adjusted OR 8.77), albumin <35 g/L (adjusted OR 3.24), serum uric acid ≥400 umol/L (adjusted OR 3.93), severe hypertension (adjusted OR 2.29), and <=1 day of medical management before delivery (adjusted OR 9.34).

Third-trimester preeclampsia at a public tertiary obstetrics and gynecology hospital in Vietnam was characterized by a high proportion of severe cases and a very high cesarean delivery rate. Older maternal age, primigravidity, assisted conception, severe hypertension, hyperuricemia, and hypoalbuminemia were associated with worse maternal or neonatal profiles. Earlier gestational age at birth remained the strongest predictor of adverse neonatal outcomes.