ANALYSIS OF EXPECTANT VERSUS ACTIVE MANAGEMENT IN PATIENTS WITH SEVERE PREECLAMPSIA BETWEEN 24 AND 34 WEEKS OF GESTATIONAL-AGE

Objective To analyze maternal and perinatal outcome in pregnancies com plicated by severe pre-eclampsia. Study design A retrospective chart r eview of 176 patients diagnosed with severe pre-eclampsia between 24 a nd 34 weeks' gestation was performed. Comparisons were made between th e groups given active management (75 patients) and expectant managemen t (101 patients). Maternal as well as perinatal outcomes were analyzed statistically. Results There were no differences between the two grou ps in age, birth weight, admission systolic blood pressure, gestationa l age at admission and at delivery. The expectantly managed patient ha d an average latency period of 5.5 days (range 2-18 days). More signif icantly, there was no difference found between the two groups in Apgar scores, neonatal length of stay in the intensive care unit and neonat al complications, including death. Maternal abruptio placenta and pulm onary edema rate were not significantly different although the complic ations were higher in the expectant management group. Conclusions In a selected group of patients, expectant management of severe pre-eclamp sia did not seem to improve maternal and perinatal outcome. When these data were analyzed separately between 32 and 34 weeks, maternal and n eonatal morbidity and mortality were not different between the groups.