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Expectant management of severe preeclampsia presenting before 25 weeks of gestation.
Med Sci Monit. 2007 Nov; 13(11):CR523-527.MS

Abstract

BACKGROUND

The treatment of preeclampsia before 25 weeks of gestation remains controversial. The aim was to evaluate the outcome of expectant management of preeclamptic women presenting prior to 25 weeks of gestation.

MATERIAL/METHODS

During a five-year period, 55 women presenting with severe preeclampsia at or before 24 weeks and 6 days of gestation were admitted to a high-care unit for expectant management. Indications for delivery were the development of severe maternal morbidity secondary to preeclampsia. Complications were identified from individual patient and infant records.

RESULTS

Mean prolongation of gestation was 4.8+/-4.1 days (range: 1-13 days) and the mean maternal hospitalization period was 10.0+/-8.3 days (range: 2-31 days). Conservative management was associated with a 94.5% (52/55) intrauterine fetal loss rate. Of the three live-born infants, one died secondary to respiratory distress syndrome followed by neonatal sepsis and the other two survived with cognitive and motor developmental delay. HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome was diagnosed in 12 women (21.8%). Nine women (16.3%) required transfusions with blood or blood products. There was 1 case (1.8%) of eclampsia. Overall, 15 women (27.2%) had developed some maternal morbidity without any significant differences between <23 weeks' and >/=23 weeks' gestation. Nulliparity was not associated with stillbirth (p=0.8), HELLP syndrome (p=0.8), or overall maternal morbidity (p=0.7). None of the women died or required any long-term treatment.

CONCLUSIONS

Conservative management of severe preeclampsia before 25 weeks of gestation is associated with considerable perinatal mortality and morbidity. Maternal complications are relatively common, but generally short-lived.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Suleyman Demirel University School of Medicine, Isparta, Turkey. msezik@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17968301

Citation

Sezik, Mekin, et al. "Expectant Management of Severe Preeclampsia Presenting Before 25 Weeks of Gestation." Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, vol. 13, no. 11, 2007, pp. CR523-527.
Sezik M, Ozkaya O, Sezik HT, et al. Expectant management of severe preeclampsia presenting before 25 weeks of gestation. Med Sci Monit. 2007;13(11):CR523-527.
Sezik, M., Ozkaya, O., Sezik, H. T., & Yapar, E. G. (2007). Expectant management of severe preeclampsia presenting before 25 weeks of gestation. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research, 13(11), CR523-527.
Sezik M, et al. Expectant Management of Severe Preeclampsia Presenting Before 25 Weeks of Gestation. Med Sci Monit. 2007;13(11):CR523-527. PubMed PMID: 17968301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Expectant management of severe preeclampsia presenting before 25 weeks of gestation. AU - Sezik,Mekin, AU - Ozkaya,Okan, AU - Sezik,Hulya Toyran, AU - Yapar,Elif Gul, PY - 2007/10/31/pubmed PY - 2008/2/12/medline PY - 2007/10/31/entrez SP - CR523 EP - 527 JF - Medical science monitor : international medical journal of experimental and clinical research JO - Med Sci Monit VL - 13 IS - 11 N2 - BACKGROUND: The treatment of preeclampsia before 25 weeks of gestation remains controversial. The aim was to evaluate the outcome of expectant management of preeclamptic women presenting prior to 25 weeks of gestation. MATERIAL/METHODS: During a five-year period, 55 women presenting with severe preeclampsia at or before 24 weeks and 6 days of gestation were admitted to a high-care unit for expectant management. Indications for delivery were the development of severe maternal morbidity secondary to preeclampsia. Complications were identified from individual patient and infant records. RESULTS: Mean prolongation of gestation was 4.8+/-4.1 days (range: 1-13 days) and the mean maternal hospitalization period was 10.0+/-8.3 days (range: 2-31 days). Conservative management was associated with a 94.5% (52/55) intrauterine fetal loss rate. Of the three live-born infants, one died secondary to respiratory distress syndrome followed by neonatal sepsis and the other two survived with cognitive and motor developmental delay. HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome was diagnosed in 12 women (21.8%). Nine women (16.3%) required transfusions with blood or blood products. There was 1 case (1.8%) of eclampsia. Overall, 15 women (27.2%) had developed some maternal morbidity without any significant differences between <23 weeks' and >/=23 weeks' gestation. Nulliparity was not associated with stillbirth (p=0.8), HELLP syndrome (p=0.8), or overall maternal morbidity (p=0.7). None of the women died or required any long-term treatment. CONCLUSIONS: Conservative management of severe preeclampsia before 25 weeks of gestation is associated with considerable perinatal mortality and morbidity. Maternal complications are relatively common, but generally short-lived. SN - 1234-1010 UR - https://www.unboundmedicine.com/medline/citation/17968301/Expectant_management_of_severe_preeclampsia_presenting_before_25_weeks_of_gestation_ L2 - https://www.medscimonit.com/download/index/idArt/512932 DB - PRIME DP - Unbound Medicine ER -