Expectant management of severe pre-eclampsia in the mid-trimester

Objective: To determine maternal and perinatal outcomes with expectant mana gement of severe pre-eclampsia in the mid-trimester, using a defined entry point. Design: Prospective case series. Thirty-nine women admitted from 24 to 27 week's gestation with severe preeclampsia, whose pregnancies were oth erwise stable, were managed expectantly with careful clinical and biochemic al monitoring of maternal and foetal status, together with careful blood pr essure control, in a high-care obstetric ward. The aim was to safely prolon g the pregnancies and thereby improve perinatal outcome. Results: Gestation was prolonged by a median of 12 (range 3-47) days, with greater periods ga ined at earlier gestations. The overall perinatal loss was 26% and the neon atal loss 17%, The rates of significant maternal complications were low. Co nclusion: Expectant management of selected women with severe pre-eclampsia from 24 to 27 weeks' gestation in a tertiary care unit is acceptably safe a nd improves perinatal outcome. (C) 2001 Elsevier Science ireland Ltd. All r ights reserved.