Hospitalized late preterm mild preeclamptic patients with mature lung testing: what are the risks of delivery?

Abstract

Objective: To evaluate the risk of elective delivery of hospitalized patients with isolated mild preeclampsia with mature fetal lung profile compared with a cohort of patients who had preeclampsia with indicated delivery matched for gestational age.Study Design: Patients with mild preeclampsia requiring hospitalization between 34 and 37 weeks estimated gestational age were offered amniocentesis for assessment of fetal lung maturity. If fetal lung maturity was documented, patients were offered delivery. These cases were then compared with indicated or spontaneously delivered controls with preeclampsia matched for gestational age.Result: A total of 51 cases were identified and matched with 51 controls. Sixteen case neonates (31.4%) were admitted to neonatal intensive care unit compared with 21 controls (41.2%). Five cases (9.8%) in each group developed respiratory distress syndrome (RDS). Conclusion:Elective delivery of mild preeclampsia with mature lung profiles in the late preterm gestation is not without neonatal risks, including a 10% risk of RDS in this series.

Neonatal morbidity after documented fetal lung maturity in late preterm and early term infants

“…16 In one study of late preterm infants, 34–37 weeks’ gestation, who were born to hospitalized women with mild preeclampsia after positive fetal lung maturity testing, 10% of the infants had RDS. 17 Clearly, the continued occurrence of RDS, despite documented fetal lung maturity, indicates that substantial opportunity still exists for improved fetal lung maturity testing.…”

Use of Antenatal Corticosteroids in the Management of Preterm Delivery

“…98 The significance of FLM testing in the LP period is questionable as other studies have found higher rates of RDS among infants born after testing mature. [99][100][101] A summary of studies that evaluated the effect of ACS in late preterm infants is presented in ►Table 2.…”

Cohort study finds newborn respiratory complications less common when mothers of babies with fetal lung immaturity at 34–37 weeks’ gestation given antenatal steroids

“…With the retirement of the most popular fetal lung maturity test, the FLM-TDx II (the test used in this study), the current methods of fetal lung maturity testing are imperfect in their prediction of respiratory morbidity. Several studies have shown that despite mature fetal lung indices, infants continue to have other respiratory and neonatal morbidities related to prematurity 1. Thus amniocentesis for this purpose is being performed with less frequency.…”