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Perinatal results of hemodynamic and conservative temporizing treatment in severe pre-eclampsia
W Visser1, M G van Pampus, P E Treffers
1Department of Obstetrics and Gynaecology, Erasmus University School of Medicine and Health Sciences, Rotterdam, The Netherlands.
Objective:
To evaluate maternal and perinatal outcome of hemodynamic temporizing management in severe pre-eclampsia.
Design:
Study group of 57 pre-eclamptic women, gestational age 35 weeks or less, treated with plasma volume expansion and vasodilatation under invasive hemodynamic monitoring, retrospectively matched with a control group treated in another center without volume expansion and invasive monitoring.
Results:
In both groups pregnancy was prolonged with 10-11 days. Maternal morbidity was low in both groups. No complications of hemodynamic monitoring were observed. Perinatal mortality was not significantly different between the study group (7.1%) and the control group (14.3%). SGA-infants were significantly less frequent in the study group (9%) than in controls (33%).
Conclusion:
Temporizing treatment of patients with early severe pre-eclampsia, with or without plasma volume expansion and invasive hemodynamic monitoring, may reduce neonatal mortality and morbidity. The difference in birthweight between study group and control group may be an effect of the therapy or may be caused by selection bias. The perinatal outcome in the study group suggests that there may be a subgroup of patients who might benefit from hemodynamic treatment.