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Rev Med Inst Mex Seguro Soc. 2018 Nov 30;56(4):379-386.

Maternal and perinatal outcomes of expectant treatment of severe preeclampsia

[Article in Spanish; Abstract available in Spanish from the publisher]

Author information

1
Instituto Mexicano del Seguro Social, Hospital de Ginecología y Obstetricia No. 3 “Dr. Víctor Manuel Espinoza de los Reyes Sánchez”, Unidad de Cuidados Intensivos. Ciudad de México, México

Abstract

in English, Spanish

Background:

In severe preeclampsia (SP), pregnancy interruption is the first recommendation. However, some patients receive expectant treatment.

Objetive:

To determine maternal and perinatal results of expectant treatment of SP in the intensive care unit (ICU) of a high-specialty hospital.

Methods:

Observational, descriptive and retrospective study; the files of 40 pregnant patients with SP managed in the ICU with expectant treatment were reviewed. The prolongation of the pregnancy, the maternal and perinatal complications, the stay in ICU and in the hospital were recorded. Descriptive statistics were used for statistical analysis.

Results:

Mean maternal age was 30.2 ± 5.04 years and gestational age 30.02 ± 3.18 weeks. Gestation was prolonged 7.5 ± 0.95 days. Maternal complications occurred in 60% (24 cases): thrombocytopenia 48.9%, HELLP syndrome 17.8%, pulmonary edema 4.45%, acute kidney injury 4.45%, deterioration of chronic kidney disease 4.45%, oligohydramnios 4.45%, uterine hemorrhage 4.45%, platelet transfusion 4.45%, eclampsia 2.2%, intravascular coagulation 2.2%, surgical reintervention 2.2%, without mortality. ICU stay was 3.42 ± 1.85 days and hospital stay 8.8 ± 4.82 days. 41 premature newborns were treated (100%) and complications were reported in 74.20% (23 cases): respiratory insufficiency 53.65%, neonatal intensive care 39.02%, growth restriction 21.95%, unreliable fetal status 9.75% and mortality 24.39%. Intensive care stay was 8.5 ± 5.47 days and hospital stay 26.8 ± 23.2 days.

Conclusions:

Prolongation of pregnancy was similar to what has been reported in previous studies. Due to the high percentage of maternal and perinatal complications, expectant treatment is not recommended.

KEYWORDS:

Pregnancy Complications; Pregnancy, High-Risk; Pre-Eclampsia; Conservative Treatment; Critical Care; Perinatal Care

PMID:
30521741

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