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Expectant Management of Severe Preeclampsia in Pregnant Women Remote from Term: A Randomised Controlled Study

Annapoorna Yalla, Flat No - 103, D.no - 3-321/5, JSN Raju Residency, Spinning Mill Colony 2. Lalacheruvu, Rajahmundry, Andhra Pradesh - 533106. , Annapoorna Yalla* , Rani S.** , Ganapathi Swamy Chintada***

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Indian Journal of Obstetrics and Gynecology 5(3):p 372-378, Jul-Sep 2017. | DOI: http://dx.doi.org/10.21088/ijog.2321.1636.5317.9

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Abstract

Introduction: Severe preeclampsia remote from term, a clinical challenge arises in the 0.3% of pregnancies in which hypertension develops before 34 weeks. The decision to deliver at early gestational age (GA) requires weighing the risks of iatrogenic prematurity against the risks of prolonging the pregnancy which is also called expectant management. Aims & Objectives: To study the effect of expectant management of severe peelcampsiaon pregnancy outcome. Material and Methods: Patients presenting with signs and symptoms of severe preeclampsia Presence of 2+ or more proteinuria on dipstick, Systolic blood pressure >/=160 mm of Hg and diastolic blood pressure >/=100mm of Hg, presence of one or more imminent signs of eclampsia ) and gestational age 26-34 weeks were randomized (into either G1(n=50) i.e. expectant management group or G2 (n=55) aggressive management group) after thorough clinical examination, laboratory testing, ultrasonography. Results: Parameters such as age, parity, body mass index, gestational age, blood pressure at admission, presence of imminent signs and all laboratory investigations are similar in both the groups.The mean prolongation of pregnancy was 9.9 in the expectant group, with an averagefetal weight gain of 150 gms. There is significant (p<0.005) improvement in neonatal survival, birth weight, need for NICU stay and ventilatory support without maternal morbidity in expectant group. Conclusion: Though there are controversies between the previous randomised studies, our study Established a higher perinatal survival and birthweight without causing increased morbidity to mother and neonate especially in neonates <30 wks GA

Keywords: Expectant Management; Perinatal Mortality; Stillbirth; Severe Preeclampsia; 26-30 Weeks. 

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.5317.9

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