Expectant management of severe pre-eclampsia in the mid-trimester

Objective: To determine maternal and perinatal outcomes with expectant management of severe pre-eclampsia in the mid-trimester, using a defined entry point. Design: Prospective case series. Thirty-nine women admitted from 24 to 27 week's gestation with severe preeclampsia, whose pregnancies were otherwise stable, were managed expectantly with careful clinical and biochemical monitoring of maternal and foetal status, together with careful blood pressure control, in a high-care obstetric ward. The aim was to safely prolong the pregnancies and thereby improve perinatal outcome. Results: Gestation was prolonged by a median of 12 (range 3-47) days, with greater periods gained at earlier gestations. The overall perinatal loss was 26% and the neonatal loss 17%, The rates of significant maternal complications were low. Conclusion: Expectant management of selected women with severe pre-eclampsia from 24 to 27 weeks' gestation in a tertiary care unit is acceptably safe and improves perinatal outcome. (C) 2001 Elsevier Science ireland Ltd. All rights reserved.