01 November 2007
Expectant management of severe preeclampsia presenting before 25 weeks of gestation
Mekin Sezik, Okan Ozkaya, Hulya Toyran Sezik, Elif Gul YaparMed Sci Monit 2007; 13(11): CR523-537 :: ID: 512932
Abstract
Background: The treatment of preeclampsia before 25 weeks of gestation remains controversial. The aim was to evaluate the outcome of expectant management of preeclamptic women presenting prior to 25 weeks of gestation.
Material/Methods: During a five-year period, 55 women presenting with severe preeclampsia at or before 24 weeks and 6 days of gestation were admitted to a high-care unit for expectant management. Indications for delivery were the development of severe maternal morbidity secondary to preeclampsia. Complications were identified from individual patient and infant records.
Results: Mean prolongation of gestation was 4.8±4.1 days (range: 1–13 days) and the mean maternal hospitalization period was 10.0±8.3 days (range: 2–31 days). Conservative management was associated with a 94.5% (52/55) intrauterine fetal loss rate. Of the three live-born infants, one died secondary to respiratory distress syndrome followed by neonatal sepsis and the other two survived with cognitive and motor developmental delay. HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome was diagnosed in 12 women (21.8%). Nine women (16.3%) required transfusions with blood or blood products. There was 1 case (1.8%) of eclampsia. Overall, 15 women (27.2%) had developed some maternal morbidity without any significant differences between <23 weeks’ and ≥23 weeks’ gestation. Nulliparity was not associated with stillbirth (p=0.8), HELLP syndrome (p=0.8), or overall maternal morbidity (p=0.7). None of the women died or required any long-term treatment.
Conclusions: Conservative management of severe preeclampsia before 25 weeks of gestation is associated with considerable perinatal mortality and morbidity. Maternal complications are relatively common, but generally short-lived.
Keywords: Eclampsia - therapy, Fetal Death, Gestational Age, HELLP Syndrome - therapy, Infant, Newborn, Pre-Eclampsia - therapy, Pregnancy, Pregnancy Outcome, Turkey
Editorial
01 April 2024 : Editorial
Editorial: Forty Years of Waiting for Prevention and Cure of HIV Infection – Ongoing Challenges and Hopes for Vaccine Development and Overcoming Antiretroviral Drug ResistanceDOI: 10.12659/MSM.944600
Med Sci Monit 2024; 30:e944600
In Press
05 Mar 2024 : Clinical Research
Effects of Thermal Insulation on Recovery and Comfort of Patients Undergoing Holmium Laser LithotripsyMed Sci Monit In Press; DOI: 10.12659/MSM.942836
05 Mar 2024 : Clinical Research
Role of Critical Shoulder Angle in Degenerative Type Rotator Cuff Tears: A Turkish Cohort StudyMed Sci Monit In Press; DOI: 10.12659/MSM.943703
06 Mar 2024 : Clinical Research
Comparison of Outcomes between Single-Level and Double-Level Corpectomy in Thoracolumbar Reconstruction: A ...Med Sci Monit In Press; DOI: 10.12659/MSM.943797
21 Mar 2024 : Meta-Analysis
Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, a...Med Sci Monit In Press; DOI: 10.12659/MSM.943863
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952