Seminars in Perinatology
Volume 33, Issue 3 , Pages 143-151 , June 2009

Expectant Management in Pregnancies with Severe Pre-eclampsia

  • Bassam Haddad, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University Paris XII, Creteil, France
    • Corresponding Author InformationAddress reprint requests to Bassam Haddad, MD, Department of Obstetrics and Gynecology, CHI Creteil, 40, Avenue de Verdun, 94010, Creteil, France
    • ,
  • Baha M. Sibai, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH

References 

  1. American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. Washington: The College; 1996;Technical Bulletin No. 219
  2. Sibai BM, Barton JR. Expectant management of severe preeclampsia remote from term: Patient selection, treatment, and delivery indications. Am J Obstet Gynecol. 2007;196:514.e1–514.e9
  3. Schiff E, Friedman SA, Mercer BM, et al. Fetal lung maturity is not accelerated in preeclamptic pregnancies. Am J Obstet Gynecol. 1993;169:1096–1101
  4. Crowley P. Antenatal corticosteroid therapy: A metal-analysis of the randomized trials, 1972-1994. Am J Obstet Gynecol. 1995;173:322–335
  5. Sibai BM, Akl S, Fairlie F, et al. A protocol for managing severe preeclampsia in the second trimester. Am J Obstet Gynecol. 1990;163:733–738
  6. Odendaal HJ, Pattinson RC, Bam R, et al. Aggressive or expectant management for patients with severe preeclampsia between 28-34 weeks' gestation: A randomized controlled trial. Obstet Gynecol. 1990;76:1070–1075
  7. Sibai BM, Mercer BM, Schiff E, et al. Aggressive versus expectant management of severe preeclampsia at 28-32 weeks' gestation: A randomized controlled trial. Am J Obstet Gynecol. 1994;171:818–822
  8. Pattinson RC, Odendaal HJ, du Toit R. Conservative management of severe proteinuric hypertension before 28 weeks' gestation. S Afr Med J. 1988;73:516–518
  9. Gaugler-Senden IP, Huijssoon AG, Visser W, et al. Maternal and perinatal outcome of preeclampsia with an onset before 24 weeks' gestation (Audit in a tertiary referral center). Eur J Obstet Gynecol Reprod Biol. 2006;128:216–221
  10. Budden A, Wilkinson L, Buksh MJ, et al. Pregnancy outcome in women presenting with pre-eclampsia at less than 25 weeks gestation. Aust N Z J Obstet Gynaecol. 2006;46:407–412
  11. Sezik M, Tuncay G, Yapar EG. Prediction of adverse neonatal outcomes in preeclampsia by absent or reversed end-diastolic flow velocity in the umbilical artery. Gynecol Obstet Invest. 2004;57:109–113
  12. Bombrys AE, Barton JR, Nowacki EA, et al. Expectant management of severe preeclampsia at less than 27 weeks' gestation: Maternal and perinatal outcomes according to gestational age by weeks at onset of expectant management. Am J Obstet Gynecol. 2008;199:e1–e6
  13. Odendaal HJ, Pattinson RC, du Toit R. Fetal and neonatal outcome in patients with severe pre-eclampsia before 34 weeks. S Afr Med J. 1987;71:555–558
  14. Olah KS, Redman CW, Gee H. Management of severe, early pre-eclampsia: Is conservative management justified?. Eur J Obstet Gynecol Reprod Biol. 1993;51:175–180
  15. Visser W, Wallenburg HC. Maternal and perinatal outcome of temporizing management in 254 consecutive patients with severe pre-eclampsia remote from term. Eur J Obstet Gynecol Reprod Biol. 1995;63:147–154
  16. Visser W, Wallenburg HC. Temporising management of severe pre-eclampsia with and without the HELLP syndrome. Br J Obstet Gynaecol. 1995;102:111–117
  17. Hall DR, Odendaal HJ, Steyn DW, et al. Expectant management of early onset, severe pre-eclampsia: Maternal outcome. Br J Obstet Gynaecol. 2000;107:1252–1257
  18. Hall DR, Odendaal HJ, Kirsten GF, et al. Expectant management of early onset, severe pre-eclampsia: Perinatal outcome. Br J Obstet Gynaecol. 2000;107:1258–1264
  19. Vigil-De Gracia P, Montufar-Rueda C, Ruiz J. Expectant management of severe preeclampsia and preeclampsia superimposed on chronic hypertension between 24 and 34 weeks' gestation. Eur J Obstet Gynecol Reprod Biol. 2003;107:24–27
  20. Haddad B, Deis S, Goffinet F, et al. Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation. Am J Obstet Gynecol. 2004;190:1590–1597
  21. Oettle C, Hall D, Roux A, et al. Early onset severe pre-eclampsia: Expectant management at a secondary hospital in close association with a tertiary institution. Br J Obstet Gynaecol. 2005;112:84–88
  22. Bombrys AE, Barton JR, Habli M, et al. Expectant management of severe preeclampsia at 270/7-336/7 weeks' gestation: Maternal and perinatal outcomes according to gestational age by X weeks at onset of expectant management. Am J Perinatol. 2009;(in press)
  23. Chammas MF, Nguyen TM, Li MA, et al. Expectant management of severe preterm preeclampsia: Is intrauterine growth restriction an indication for immediate delivery?. Am J Obstet Gynecol. 2000;183:853–858
  24. Shear RM, Rinfret D, Leduc L. Should we offer expectant management in cases of severe preterm preeclampsia with fetal growth restriction?. Am J Obstet Gynecol. 2005;192:1119–1125
  25. Haddad B, Kayem G, Sies S, et al. Are perinatal and maternal outcomes different during expectant management of severe preeclampsia in the presence of intrauterine growth restriction?. Am J Obstet Gynecol. 2007;196:237.e1–237.e5
  26. Karsdorp VHM, van Vugt JMG, van Geijn HP, et al. Clinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery. Lancet. 1994;344:1664–1668
  27. Yoon BH, Lee CM, Kim SW. An abnormal umbilical artery waveform: A strong and independent predictor of adverse perinatal outcome in patients with preeclampsia. Am J Obstet Gynecol. 1994;171:713–721
  28. Pattinson RC, Norman K, Odendaal HJ. The role of Doppler velocimetry in the management of high risk pregnancies. Br J Obstet Gynaecol. 1994;101:114–120
  29. Guzman ER, Vintzileos AM, Martins M, et al. The efficacy of individual computer heart rate indices in detecting acidemia at birth in growth-restricted fetuses. Obstet Gynecol. 1996;87:969–974
  30. Serra V, Moulden M, Bellver J, et al. The value of the short-term fetal heart rate variation for timing the delivery of growth-retarded fetuses. Br J Obstet Gynaecol. 2008;115:1101–1107
  31. Amorim MM, Santos LC, Faundes A. Corticosteroid therapy for prevention of respiratory distress syndrome in severe preeclampsia. Am J Obstet Gynecol. 1999;180:1283–1288
  32. Schiff E, Friedman SA, Kao L, et al. The importance of urinary excretion during conservative management of severe preeclampsia. Am J Obstet Gynecol. 1996;175:1313–1316
  33. Hall DR, Odendaal HJ, Stein DW, et al. Urinary protein excretion and expectant management of early onset, severe preeclampsia. Int J Gynecol Obstet. 2002;77:1–6
  34. Chua S, Redman CWG. Prognosis for preeclampsia complicated by 5g or more of proteinuria in 24 hours. Eur J Obstet Gynecol Reprod Biol. 1992;43:9–12
  35. Newman MG, Robichaux AG, Stedman CM, et al. Perinatal outcomes in preeclampsia that is complicated by massive proteinuria. Am J Obstet Gynecol. 2003;188:264–268
  36. Ganzevoort W, Rep A, Bonsel GJ, et al. A randomised controlled trial comparing two temporising management strategies, one with and one without plasma volume expansion, for severe and early onset pre-eclampsia. Br J Obstet Gynaecol. 2005;112:1358–1368
  37. Chari RS, Friedman SA, O'Brien JM, et al. Daily antenatal testing in women with severe preeclampsia. Am J Obstet Gynecol. 1995;17:1207–1210
  38. Hall DR, Odendaal JH, Steyn DW. Delivery of patients with early onset, severe preeclampsia. Int J Gynecol Obstet. 2001;74:143–150
  39. Alanis MC, Robinson CJ, Hulsey TC, et al. Early onset severe preeclampsia: Induction of labor vs. elective Cesarean delivery and neonatal outcomes. Am J Obstet Gynecol. 2008;199:262.e1–262.e6

PII: S0146-0005(09)00006-8

doi: 10.1053/j.semperi.2009.02.002

Seminars in Perinatology
Volume 33, Issue 3 , Pages 143-151 , June 2009

Article Tools

* Image Usage & Resolution