Evaluation of expectant management of severe preeclampsia remote from term randomized clinical trial

Abstract EN

Objective: to evaluate the expectant management of severe preeclampsia with gestational age between 28 -33 weeks and to compare maternal and fetal outcomes of the expectant management with early delivery within 24- 48 hours.

Patients and methods: This study was performed on 170 patients with severe preeclampsia between 28 – 33 weeks gestation at Al-salam Hospital, Sadah, Republic of Yemen, between the periods from October 2o12 to November 2014.

These women randomized divided into two groups; the early delivery group (group1) in whom delivery was planned after 24-48 hours and expectant management group (group2) in whom delivery was conducted only for specific maternal or fetal conditions or reached 34 weeks gestation.

Results: There were significant increase in pregnancy prolongation, 1 minute and 5 Apgar score, birth weight and decrease in NICU admission in group2 than in group1.

NICU stays, RDS, neonatal sepsis, intraventricular hemorrhage, necrotizing enterocolitis and perinatal deaths were more in (group1) than in (group2) and the differences was not significant in isolated morbidity but was significant in the total morbidity.

There were increased in the incidence of cesarean delivery and maternal morbidity in the group2 than in the group1 but differences were not significant.

Conclusion and recommendation: the expectant management of severe preeclampsia significant decreased the neonatal morbidity, NICU admission and insignificant increased the maternal morbidity.

The expectant management for severe preeclampsia should offer only in special conditions in will equipped hospitals where there is ICU, NICU and strict supervision by obstetrician and neonatologist available for 24 hours