D J Murphy1, G M Stirrat. 1. St. Michael's Hospital, Southwell St., Bristol, United Kingdom.
Abstract
OBJECTIVE: To examine the management of early-onset preeclampsia and its maternal and fetal morbidity and mortality. DESIGN: Retrospective cohort study of 49,812 births at a university teaching hospital between June 1986 and March 1997. Seventy-one women were identified with a diagnosis of preeclampsia with an onset at less than 30 completed weeks of gestation. RESULTS: The incidence of very preterm preeclampsia was 1 in 682 total births. The mean diagnosis to delivery interval (range) was 14 days (0-49 days). There were no maternal deaths. Fifteen women (21%) had developed HELLP/ELLP syndrome, 9 (13%) had renal failure, 1 (1.4%) had eclampsia, and 11 (15%) had an abruption. Five women (7%) had a termination of pregnancy, 57 (80%) were delivered by cesarean section, and 4 (5%) required a classical incision. There were 12 intrauterine deaths (16%), 9 neonatal deaths (12%), and 52 neonatal survivors (72%). Two of the survivors were known to have neurological impairment at the 2-year follow-up. CONCLUSIONS: A conservative approach to the management of early-onset preeclampsia results in a good obstetric outcome for the majority of fetuses, but this must be balanced against the significant risk of morbidity to the mothers.
OBJECTIVE: To examine the management of early-onset preeclampsia and its maternal and fetal morbidity and mortality. DESIGN: Retrospective cohort study of 49,812 births at a university teaching hospital between June 1986 and March 1997. Seventy-one women were identified with a diagnosis of preeclampsia with an onset at less than 30 completed weeks of gestation. RESULTS: The incidence of very preterm preeclampsia was 1 in 682 total births. The mean diagnosis to delivery interval (range) was 14 days (0-49 days). There were no maternal deaths. Fifteen women (21%) had developed HELLP/ELLP syndrome, 9 (13%) had renal failure, 1 (1.4%) had eclampsia, and 11 (15%) had an abruption. Five women (7%) had a termination of pregnancy, 57 (80%) were delivered by cesarean section, and 4 (5%) required a classical incision. There were 12 intrauterine deaths (16%), 9 neonatal deaths (12%), and 52 neonatal survivors (72%). Two of the survivors were known to have neurological impairment at the 2-year follow-up. CONCLUSIONS: A conservative approach to the management of early-onset preeclampsia results in a good obstetric outcome for the majority of fetuses, but this must be balanced against the significant risk of morbidity to the mothers.
Authors: Vanessa R Ribeiro; Mariana Romao-Veiga; Graziela G Romagnoli; Mariana L Matias; Priscila R Nunes; Vera Therezinha M Borges; Jose C Peracoli; Maria Terezinha S Peracoli Journal: Immunology Date: 2017-06-19 Impact factor: 7.397
Authors: Véronique Taché; Rebecca J Baer; Robert J Currier; Chin-Shang Li; Dena Towner; L Elaine Waetjen; Laura L Jelliffe-Pawlowski Journal: Am J Obstet Gynecol Date: 2014-03-14 Impact factor: 8.661