Early pre-eclampsia: What proportion of women qualify for expectant management and if not, why not?

Date
2006
Authors
Hall D.R.
Grove D.
Carstens E.
Journal Title
Journal ISSN
Volume Title
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Abstract
Objective: To determine what proportion of women with early pre-eclampsia qualify for expectant management and the magnitude of factors excluding this approach. Study design: A prospective case series with continuous data capture over one year at a tertiary referral centre. All women (n = 169) with singleton pregnancies, presenting with early (≥20 and <34 weeks' gestation) pre-eclampsia, were admitted, stabilised and evaluated. Major maternal or fetal complications at this stage were indications for delivery. However, when the pregnancy was otherwise stable, expectant management was commenced if the gestation was ≥24 weeks. Termination was offered from 20 to 23 weeks' gestation. Results: Of the 169 women admitted, 82 (48.5%) were managed expectantly and 87 (51.5%) delivered after stabilisation and evaluation. Early fetal distress (32%) and major maternal complications (28%) were the most frequent reasons preventing expectant management. Ascites (18%) and HELLP syndrome (13%) ranked highest amongst the maternal complications. Conclusions: In this study, almost half of the women presenting with early onset pre-eclampsia qualified for expectant management. Early fetal distress was the most frequent reason preventing expectant management. © 2006 Elsevier Ireland Ltd. All rights reserved.
Description
Keywords
antihypertensive agent, betamethasone, adolescent, adult, article, ascites, controlled study, delivery, female, fetus distress, gestation period, gestational age, HELLP syndrome, human, major clinical study, preeclampsia, pregnancy, pregnancy complication, pregnancy termination, priority journal, prospective study, treatment indication, Adolescent, Adult, Female, Fetal Distress, Humans, Patient Care Management, Pre-Eclampsia, Pregnancy, Pregnancy Outcome, Prenatal Care, Prospective Studies, South Africa
Citation
European Journal of Obstetrics Gynecology and Reproductive Biology
128
1-2