Recent advances in the management of preeclampsia

The past decade has been characterized by few advances regarding the pathophysiology and prevention but many changes in the clinical treatment of patients with preeclampsia. Specifically, recommendations have been made for home or day-care management of a select group of patients with mild gestational hypertension or preeclampsia. Moreover, three randomized clinical trials revealed that expectant management with close monitoring of maternal and fetal conditions is possible in a select group of patients with severe preeclampsia at less than 34 weeks' gestation. In addition, the efficacy of magnesium sulfate in the prevention and control of eclamptic convulsion has been validated in randomized controlled trials performed worldwide. In contrast, recent randomized trials failed to demonstrate any major benefit from the routine use of low-dose aspirin in pregnancy, whereas a recent meta-analysis found calcium supplementation during pregnancy to be effective in reducing the risk of hypertension.