111 Intrapartum outcomes of women with and without preeclampsia: A cohort study

Abstract

Introduction Observational studies suggest benefits with vaginal delivery in preeclampsia but the ideal mode of delivery remains to be stablished. This study aims to compare maternal and perinatal outcomes between intrapartum women with and without preeclampsia. Methods A cohort prospective study was conducted in a school maternity in Campina Grande, Brazil, analyzing data from a program of humanizing childbirth. The only inclusion criterion was presence of active phase of labor (6 cm), spontaneous or induced. Maternal characteristics were analyzed and maternal and perinatal outcomes were compared. Statistical analysis was performed using Epi Info 7.2. Chi-square test and Fisher exact test were used at a 5% level of significance. Results A total of 563 intrapartum women were enrolled, 54 women with preeclampsia (48 with severe preeclampsia) and 511 without preeclampsia. Gestational age varied between 34 and 39 weeks in women with preeclampsia and 28 and 43 weeks in controls. All women with severe preeclampsia received magnesium sulphate. Frequency of labor induction and oxytocin use were greater among patients with preeclampsia (29,6% vs. 8% and 37% vs. 9% respectively). The rate of cesarean section was similar (7,4% vs. 8,4%). There were three cases of postpartum hemorrhage among women without preeclampsia. No case of eclampsia occurred. Instrumental delivery was more frequent among women with preeclampsia (12,9% vs. 5,9%). Birthweight was similar and Apgar score Conclusion When spontaneous or induced labor are present, women with preeclampsia have more interventions during labor but a similar rate of cesarean section when compared with women without preeclampsia. Perinatal outcomes are not different. These results should encourage trial of labor in women with preeclampsia beyond 34 weeks.