This study aims to evaluate maternal and perinatal outcomes among cases of planned and emergency cesarean section in PE with severe features. Retrospective cohort study with 202 women diagnosed with severe pre-eclampsia, with gestational age greater than 32 weeks. They were divided according to the mode of delivery: vaginal delivery, planned cesarean section and emergency cesarean section. Were analyzed the sociodemographic characteristics, obstetric history and clinical conditions at admission, post operatory maternal and perinatal outcomes and complications according to the type mode of delivery. A total 202 patients were included in the study, 78.7% of whom underwent planned cesarean section, 21.3% emergency cesarean sections and only 11.8% induced labor was performed and of the total. Only 2% of total progressed to vaginal delivery. Patients living in the interior (53.5%, P 0.040), primiparous (OR 1.4, P <0.001), history of previous pre-eclampsia (OR 1.3, P = 0.020) and presence of signs of severity (OR 10.1, P <0.001) had a higher risk of evolving to an emergency cesarean section. Postpartum hemorrhage was greater in the programmed cesarean section (OR 2.4, P 0.049). Regarding perinatal complications, the time of fetal hospitalization in days was longer in the programmed cesarean section (OR 6.7, P 0.035). These results demonstrate that there is a high rate of indication for cesarean sections (98%) in patients with severe preeclampsia. A high rate of cesarean section does not positively affect the indicators of maternal and neonatal morbidity and mortality. In addition, in women in whom delivery was induced, there was no increase in neonatal risks..
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