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

Abstract 

Objective: To determine maternal and perinatal outcomes with expectant management 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 pre-eclampsia, whose pregnancies were otherwise stable, were managed expectantly with careful clinical and biochemical monitoring of maternal and foetal status, together with careful blood pressure control, in a high-care obstetric ward. The aim was to safely prolong the pregnancies and thereby improve perinatal outcome. Results: Gestation was prolonged by a median of 12 (range 3–47) days, with greater periods gained at earlier gestations. The overall perinatal loss was 26% and the neonatal loss 17%. The rates of significant maternal complications were low. Conclusion: Expectant management of selected women with severe pre-eclampsia from 24 to 27 weeks’ gestation in a tertiary care unit is acceptably safe and improves perinatal outcome.

Keywords:  Pre-eclampsia, Mid-trimester, Expectant management