Induction or caesarean section for preterm pre-eclampsia?

Controversy continues over the mode of delivery in severe pre-eclampsia remote from term. The aim of this study was to assess prospectively the mode of delivery in severe pre-eclampsia remote from term. The clinical data of 108 women who presented consecutively with severe pre-eclampsia over a 1-year period was used for the study material. Sixty-eight (63%) patients were delivered by elective caesarean section and 40 (37%) underwent induction of labour. Twenty-six had a vaginal delivery following induction, the others (n = 14) had emergency caesarean section. No baby with a gestational age of < or = 27 weeks survived after delivery. Perinatal mortality was highest for the babies delivered following induction of labour (vaginal delivery vs. caesarean section after induction of labour, P = 0.0004; vaginal delivery vs. elective caesarean section, P = 0.002). Severe pre-eclampsia remote from term is associated with a high caesarean section rate. In this study, carried out in a developing country, elective caesarean section contributed to a better perinatal outcome than vaginal delivery or emergency caesarean section following induction of labour.