Expectant management of severe preeclampsia and preeclampsia superimposed on chronic hypertension between 24 and 34 weeks’ gestation

Gracia, Paulino Vigil-De; Montúfar-Rueda, Carlos; Ruiz, Juan Carlos

doi:10.1016/s0301-2115(02)00269-5

Cited by 82 publications

(46 citation statements)

References 12 publications

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“…They also suggested that perinatal outcomes after expectant management were not different in women with superimposed preeclampsia compared to severe preeclampsia. 10 In addition to these findings, we did not find significant differences in frequencies of neonatal and maternal deaths and maternal near miss cases between the two groups.…”

Section: Discussionsupporting

confidence: 55%

The Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia

Şimşek¹,

Uludağ²,

Tüten³

et al. 2017

Turkiye Klinikleri J Gynecol Obst

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here is an increasing tendency towards delayed childbearing. The risk of hypertensive disorders in pregnancy increases gradually with age. 1 The hypothesis that superimposed preeclampsia results in worseThe Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: This study was performed to compare the obstetric outcomes between preeclampsia and superimposed preeclampsia cases. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This retrospective study included 500 women with preeclampsia and 101 women with superimposed preeclampsia who delivered in a tertiary care center. Clinical findings, maternal and perinatal outcomes were compared between the two groups. R Re es su ul lt ts s: : In cases of preeclampsia, antenatal, perinatal, neonatal mortality rates were 13.4%, 17.9%, 5.1% respectively. The rate of cases which mother's life at risk was 30.2%. The antenatal, perinatal and neonatal mortality rates were 12.9%, 19.8%, and 8.9%, respectively, in cases of superimposed preeclampsia and the rate of cases where mother's life was at risk was 25.7%. There was no significant difference between the two groups in terms of time of onset of the symptoms (p = 0.669), mean birth week (p = 0.410) and birth weight (p= 0.340). Rates of intrauterine growth retardation (p = 0.434), early and late neonatal loss (p = 0.111, p = 0.848) and stillbirth (p = 0.887) did not differ between the groups. Although maternal deaths and maternal near miss cases were not significantly different between the two groups (p=0.370), the rate of complication with eclampsia in preeclampsia cases was higher than that of superimposed preeclampsia cases (p=0.001). C Co on nc cl lu us si io on n: : Preeclampsia and superimposed preeclampsia have similar obstetric outcomes. Further research is needed to elucidate the mechanisms underlying eclampsia in preeclampsia cases.K Ke ey yw wo or rd ds s: : Pre-eclampsia; perinatal mortality; maternal mortality; pregnancy outcome Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışma preeklampsi ve süperimpoze preeklampsi olgularının obstetrik sonuçlarını karşılaştırmak amacıyla gerçekleştirilmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : B Bu u ç ça al lı ış şm ma ay ya a ü üç çü ün nc cü ü b ba as sa am ma ak k bir sağlık biriminde doğumları gerçekleştirilen 500 preeklampsili ve 101 süperimpoze preeklampsili gebe dahil edildi. Hasta dosyaları geriye dönük olarak incelendi. İki grup arasında klinik bulgular, maternal ve perinatal sonuçlar karşılaştırıldı. B Bu ul lg gu ul la ar r: : Preeklampsi olgularında antenatal, perinatal ve neonatal mortalite oranları sırasıyla %13.4, %17.9, %5.1, anne hayatının risk altında olduğu olguların oranı %30.2 idi. Süperimpoze preeklampsi olgularında antenatal, perinatal ve neonatal mortalite oranları sırasıyla %12.9, %19.8, %8.9, anne hayatının risk altında olduğu olguların oranı %25.7 idi. Semptomların ortaya çıkış zamanı (p: 0.669), ortalama doğum haftası (p: 0.410) ve doğum kilosu (p: 0.340) açıs...

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Section: Discussionsupporting

confidence: 55%

The Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia

Şimşek¹,

Uludağ²,

Tüten³

et al. 2017

Turkiye Klinikleri J Gynecol Obst

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“…For each death nearly 118 women suffer from life threatening events or severe acute morbidity 1 . Hypertensive disorders of pregnancy seem to be one of the major causes of maternal morbidity and mortality leading to 10-15% of maternal deaths specially in the developing world 2 . Recent work has suggested that women with mild pregnancy-induced hypertension may have improved perinatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Immediate Perinatal Outcome of Neonates with Maternal Hypertensive Disorders in Pregnancy

Hassan

Choudhury

Begum

et al. 2013

J. Nepal Paedtr. Soc.

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Introduction: Hypertensive disorders of pregnancy seem to be one of the major causes of maternal morbidity and mortality leading to 10-15% of maternal deaths especially in the developing world. This study examines the perinatal outcome of neonates with mothers having hypertensive disorder of pregnancy. Materials and Methods: Seventy three mothers and their newborn babies were selected. Mothers with Gestational hypertension, preeclampsia, eclampsia, chronic hypertension, preeclampsia superimposed on chronic hypertension were included. Gestational diabetics (GDM), chronic maternal diseases, infant of diabetic mother (IDM), babies with major congenital malformations were excluded. Results: Thirty five mothers (47.9%) had regular antenatal check up (ANC) and 38 (52%) had irregular. Nineteen mothers (26%) were primipara and 54 (74%) were multipara. Forty four mothers (60%) had positive family history or had own history of hypertensive disorder during their previous pregnancy. 13 mothers (17.8%) had normal vaginal delivery (NVD), 60 mothers (82.19%) had lower uterine cesarean section (LUCS). 30 babies (41%) were admitted. 44 mothers (60%) had gestational hypertension, 21 had (28.6%) pre-eclamtic toxemia (PET), 3 had (4.1%) eclampsia, 5 had (6.8%) essential hypertension 3 of them subsequently developed PET. Mean maternal age 26.86 years, gestational age 34.15 (±1.46)weeks among admitted and 36.30 (±1.6)weeks among non-admitted group. Mean birth weight was 1.69 (±0.39) kg. among admitted and 2.71 (±0.31) kg. in non-admitted babies. Seven pregnancies (9.58%) were twin, macerated 1 twin among was among 2 pregnancies (2.7%), 5 intra uterine death (IUD) observed in single pregnancy. Conclusion: Significant number of babies with maternal hypertensive disorder of pregnancy needed hospitalization, mean birth weight and gestational age was less than that of the non-admitted group.

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“…25 In another study conducted by Bassam Hadaad6 in 2004 on mid trimester pregnancy induced hypertension, IUGR accounts for 27% of cases. In the present perinatal mortality was high in aggressive group where pregnancy was terminated within 24 hrs, while in expectant group where pregnancy was continued the perinatal mortality was 30%.…”

Section: Fetal Complicationsmentioning

confidence: 97%

Outcome of expectant line of management in early onset (24-32weeks) pregnancy induced hypertension

Mandade

Singh

Bhavthankar

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Preeclampsia is a disease of multiple organ systems that is unique to pregnancy and is often associated with increased risk of maternal-perinatal adverse outcome, especially when it is severe and occurs well before term.The objective of the study was to study expectant line of management in early onset pregnancy induced hypertension (24-32 weeks) and its maternal and perinatal outcome in relation to preterm delivery, IUD/ Still birth, and early neonatal deaths.Methods: Total 100 patients presented with early onset pregnancy induced hypertension admitted in Pravara Medical College and Hospital. 50 patient’s pregnancy terminated (Aggressive Group) depending on patients clinical profile and other 50 patients given expectant line of management and pregnancy was prolonged (Expectant Group). Maternal and perinatal outcome was compared between the two groups.Results: No maternal mortality was seen in both groups.Perinatal mortality in aggressive line of management was 54% while in expectant line of management perinatal mortality was 30%. Neonatal deaths account for 24% in aggressive group and 10% in expectant group. Fetal survival rate in expectant group was 70% and in aggressive group it was 46%.Conclusions: Expectant management of severe preeclampsia at 24 to 32 weeks in a tertiary care center is associated with good perinatal outcome with a minimal risk for the mother.The early use of antihypertensive drugs, optimum timing of delivery and strict fluid balance will help to achieve successful outcome.

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Expectant management of severe preeclampsia and preeclampsia superimposed on chronic hypertension between 24 and 34 weeks’ gestation

Cited by 82 publications

References 12 publications

The Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia

The Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia

Immediate Perinatal Outcome of Neonates with Maternal Hypertensive Disorders in Pregnancy

Outcome of expectant line of management in early onset (24-32weeks) pregnancy induced hypertension

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