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J Obstet Gynaecol. 2002 Jul;22(4):353-6.

Induction or caesarean section for preterm pre-eclampsia?

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MRC/UN Pregnancy Hypertension Research Unit and Department of Obstetrics and Gynaecology, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.


Controversy continues over the mode of delivery in severe pre-eclampsia remote from term. The aim of this study was to assess prospectively the mode of delivery in severe pre-eclampsia remote from term. The clinical data of 108 women who presented consecutively with severe pre-eclampsia over a 1-year period was used for the study material. Sixty-eight (63%) patients were delivered by elective caesarean section and 40 (37%) underwent induction of labour. Twenty-six had a vaginal delivery following induction, the others (n = 14) had emergency caesarean section. No baby with a gestational age of < or = 27 weeks survived after delivery. Perinatal mortality was highest for the babies delivered following induction of labour (vaginal delivery vs. caesarean section after induction of labour, P = 0.0004; vaginal delivery vs. elective caesarean section, P = 0.002). Severe pre-eclampsia remote from term is associated with a high caesarean section rate. In this study, carried out in a developing country, elective caesarean section contributed to a better perinatal outcome than vaginal delivery or emergency caesarean section following induction of labour.

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