BJOG : an international journal of obstetrics and gynaecology · 2000
Expectant management of early onset, severe pre-eclampsia: maternal outcome.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hall D R, Odendaal H J, Steyn D W, Grové D
Аннотация
OBJECTIVE: To evaluate the safety and outcome of women undergoing expectant management of early onset, severe pre-eclampsia.
DESIGN: Prospective case series extending over a five-year period.
SETTING: Tygerberg Hospital, a tertiary referral centre.
POPULATION: All women (n = 340) presenting with early onset, severe pre-eclampsia, where both the mother and the fetus were otherwise stable.
METHODS: Frequent clinical and biochemical monitoring of maternal status, together with careful blood pressure control, in a high care obstetric ward.
MAIN OUTCOME MEASURES: Major maternal complications and prolongation of gestation.
RESULTS: Multigravid women constituted 67% of the group. Antenatal biochemistry was reassuring with some expected, but not severe, deteriorations. Twenty-seven percent of women experienced a major complication, but few had poor outcomes. No maternal deaths occurred. Most major complications resolved quickly, necessitating only three admissions (0.8%) to the intensive care unit. One woman required dialysis. Pregnancies were prolonged by a mean (median) number of 11 days (9) before delivery, with more time being gained at earlier gestations. The postpartum inpatient stay (89% < or =7 days, bearing in mind that 82% of women were delivered by caesarean section) was not extended.
CONCLUSION: Careful noninvasive management of early onset, severe pre-eclampsia in a tertiary centre can diminish and limit the impact of serious maternal complications. Valuable time to prolong the pregnancy and improve neonatal outcome is thereby gained.
DESIGN: Prospective case series extending over a five-year period.
SETTING: Tygerberg Hospital, a tertiary referral centre.
POPULATION: All women (n = 340) presenting with early onset, severe pre-eclampsia, where both the mother and the fetus were otherwise stable.
METHODS: Frequent clinical and biochemical monitoring of maternal status, together with careful blood pressure control, in a high care obstetric ward.
MAIN OUTCOME MEASURES: Major maternal complications and prolongation of gestation.
RESULTS: Multigravid women constituted 67% of the group. Antenatal biochemistry was reassuring with some expected, but not severe, deteriorations. Twenty-seven percent of women experienced a major complication, but few had poor outcomes. No maternal deaths occurred. Most major complications resolved quickly, necessitating only three admissions (0.8%) to the intensive care unit. One woman required dialysis. Pregnancies were prolonged by a mean (median) number of 11 days (9) before delivery, with more time being gained at earlier gestations. The postpartum inpatient stay (89% < or =7 days, bearing in mind that 82% of women were delivered by caesarean section) was not extended.
CONCLUSION: Careful noninvasive management of early onset, severe pre-eclampsia in a tertiary centre can diminish and limit the impact of serious maternal complications. Valuable time to prolong the pregnancy and improve neonatal outcome is thereby gained.