Expectant Management of Severe Preeclampsia at 27 (0/7) to 33 (6/7) Weeks' Gestation: Maternal and Perinatal Outcomes According to Gestational Age by Weeks at Onset of Expectant Management

Abstract

The aim of expectant management of severe preeclampsia between 27 (0/7) and 33 (6/7) weeks of gestation is to improve perinatal outcome without compromising maternal safety. Perinatal outcome is dependent in large part on the gestational age at the time of disease onset and maternal and fetal status at the time of presentation. This retrospective study evaluated maternal morbidity and perinatal outcome with expectant management of severe preeclampsia between 27 (0/7) and 33 (6/7) weeks' gestation, with data stratified by gestational age at the time of onset of expectant management. The investigators reviewed the medical records of 336 gravid women with severe primary or superimposed preeclampsia who delivered before 34 (0/7) weeks at an Ohio medical center, to identify a study population of 66 patients (71 fetuses) between 27 (0/7) and 33 (6/7) weeks. All patients were treated with corticosteroids for fetal lung maturity. Expectant management resulted in pregnancies being prolonged by a median of 5 days (range: 3-35). Nineteen (27%) newborns had a birth weight below the 10th percentile for gestational age, and 6 (8%) had a birth weight below the fifth percentile. Among patients in whom expectant management was instituted at 27-27 (6/7) weeks, there was 1 neonatal.