Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation

Haddad, Bassam; Deis, Stéphanie; Goffinet, François; Paniel, B. J.; Cabrol, D.; Sibai, Baha M.

doi:10.1016/j.ajog.2004.03.050

Cited by 130 publications

(81 citation statements)

References 16 publications

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“…Neonatal morbidity was clearly related to the gestational age at the onset of expectant management and this is in agreement with previous studies [9,13]. Increasing gestational age correlated with a reduction of respiratory distress syndrome [9,14]. In addition, neonatal outcome was excellent during expectant management at 32-34 weeks.…”

Section: Discussionsupporting

confidence: 91%

“…73.68 % of perinatal deaths were with a birth weight \1,000 g and gestational age \30 weeks. In contrast to one recent study [14] which did not have instances of perinatal deaths in women expectantly managed at 30 or more weeks of gestation, we had nine fetal deaths in women expectantly managed at 30 or more weeks, more than half of which were caused by abruptio placenta. We could not salvage most of these fetuses mainly because of non-affordability of the patients as well as the limitation of the neonatal intensive care unit.…”

Section: Discussionmentioning

confidence: 75%

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Maternal and Perinatal Outcome During Expectant Management of Severe Pre-Eclampsia Between 24 and 34 Weeks of Gestation

Swamy

Patil

Shailaja

2012

J Obstet Gynecol India

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Objective To determine the maternal and perinatal outcome after expectant management of severe pre-eclampsia between 24 and 34 weeks of gestation. Method The maternal and fetal status was monitored by an intensive, non-invasive method among 94 women with severe pre-eclampsia between 24 and 34 weeks of gestation who were scheduled for expectant management in the OICU at a tertiary care center. Pregnancy prolongation and maternal and perinatal morbidity and mortality were analyzed by the Student 't' test and the Mann-Whitney U test. Results The days of pregnancy prolongation and perinatal mortality were significantly higher among those managed at \30 weeks. Increasing gestational age correlated with a reduction of RDS. Maternal morbidities were significantly higher among those managed at\28 weeks. But, there was no maternal mortality. Conclusion Expectant management of severe preeclampsia at 30-34 weeks in a tertiary care center of a developing country is associated with good perinatal outcome and risk reduction for the mother.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 75%

Maternal and Perinatal Outcome During Expectant Management of Severe Pre-Eclampsia Between 24 and 34 Weeks of Gestation

Swamy

Patil

Shailaja

2012

J Obstet Gynecol India

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“…Intrauterine fetal demise at admission, prematurity, placental abruption and severe IUGR by the time eclampsia occurred would all lead to increased perinatal loss [28]. Severe IUGR reported in 24% (58) and nonsevere IUGR in 76% (181) in severe preeclampsia (239) during expectant management [28].…”

Section: Discussionmentioning

confidence: 99%

“…Severe IUGR reported in 24% (58) and nonsevere IUGR in 76% (181) in severe preeclampsia (239) during expectant management [28].…”

Section: Discussionmentioning

confidence: 99%

Management of Eclampsia and Imminent Eclampsia, Maternal and Perinatal Outcome in 666 Cases—2003-2007 at Government Maternity Hospital in Hyderabad

Devabhaktuni¹,

Addula²,

Ponnur³

et al. 2017

OJOG

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Objective: This is an audit to evaluate the maternal and perinatal outcome in eclampsia and imminent eclampsia with the management adopted at a tertiary hospital. Methods: During a period of 34 months, from [2003][2004][2005][2006][2007] at Government maternity hospital, Osmania medical college, Hyderabad, 666 women with eclampsia and imminent eclampsia were managed. The number of eclampsia and imminent eclampsia (IE) was 532 and 134, respectively. We have analyzed the clinical profile, parity, age, degree of proteinuria, the period of gestation in weeks, the antenatal care, the number of antenatal visits, referrals from other hospitals, the diastolic B.P. at the time of admission, the recurrence of convulsions and the complications. 1) All the cases of eclampsia and IE were managed with magnesium sulphate as an anticonvulsant. 2) Oral nifedipine, IV labetalol, sublingual nifedipine and nitroglycerine infusion were used to control severe hypertension. 3) Prostaglandin E1 (PGE1) was used for induction of labour (IOL) 194nary embolisim in 2, aspiration pneumonia in one and sepsis in one. The perinatal mortality was 167/582 (28.69%), PNM when birth weight was >1.5 kg was 59/426 (13.84%), intrauterine fetal deaths at admission were 54 (8.5%), there were four sets of twins. Conclusions: 1) More effective measures to control hypertension and routine administration of anticonvulsant, magnesium sulphate to women with eclampsia should be practised from the first referral unit itself. 2) Our caesarean delivery rate of 33.54% in the very high risk cases of eclampsia and imminent eclampsia is very low compared to others. 3) Induction of labour with misoprostol was successful in 81% with consequent reduction in caesarean section rate and morbidity and mortality associated with caesarean deliveries. Misoprostol has proved to be a safe and effective inducing agent in eclampsia. 4) The maternal mortality in our series is 2.55%.

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“…4 If pregnancy latency from diagnosis of eclampsia to delivery could be extended safely for both the fetus and the mother, improvement in perinatal outcomes may be achieved similar to improved maternal outcomes observed with the conservative management of severe pre-eclampsia. [5][6][7][8] We report a compassionate off-label use of digoxin-fragmented antibody on a repeated-dose, fixed schedule in a preterm pregnancy complicated by eclampsia.…”

Section: Introductionmentioning

confidence: 99%

Repeated dosing of digoxin-fragmented antibody in preterm eclampsia

et al. 2009

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Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation

Cited by 130 publications

References 16 publications

Maternal and Perinatal Outcome During Expectant Management of Severe Pre-Eclampsia Between 24 and 34 Weeks of Gestation

Maternal and Perinatal Outcome During Expectant Management of Severe Pre-Eclampsia Between 24 and 34 Weeks of Gestation

Management of Eclampsia and Imminent Eclampsia, Maternal and Perinatal Outcome in 666 Cases—2003-2007 at Government Maternity Hospital in Hyderabad

Repeated dosing of digoxin-fragmented antibody in preterm eclampsia

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