Severe preterm preeclampsia: Aggressive or expectant management?

This randomized controlled trial was done to determine whether aggressive or expectant management of severe preeclampsia at 28-33 weeks is more beneficial to maternal and fetal outcome. Forty-one women with severe preeclampsia between 28-33 weeks of gestation were recruited initially. After 24-hour observation, only 30 women were eligible for randomization into either aggressive or expectant management. Aggressive management patients were prepared for delivery, either by cesarean or induction, 48 hours after the administration of glucocorticoids. Expectant management patients were managed with bed rest, oral antihypertensive and intensive maternal and fetal monitoring. The study concluded that in a properly selected group of patients with severe preeclampsia between 28-33 weeks of gestation, expectant management with intensive maternal and fetal monitoring is more beneficial for the fetus without jeopardizing maternal safety

Intravaginal misoprostol versus oxytocin infusion for induction of labour with pre-labour rupture of membranes near term

To compare stimulation of laour by oxytocin infusion versus misoprostol [PGE[1]] in women near term with pre-labour rupture of membranes [PROM]. A prospective randomized study. Labour ward El Galaa Maternity Hospital, Cairo, Egypt. 72 women with PROM near term [>/= 35 weeks] for more than 24 hours were randomized into two groups. One groups received oxtocin infusion. The second group receved intravaginal misoprostol 100 micro g and if contraction had not commenced a further dose of 100 micro g was inserted 8 hours later. Oxytocin infusion was started if the women was not in establishe labour after another 8 hours or if augmentation was necessary after labour was stimulated by misoprostol. Length of labour, mode of delivery and incidence of maternal and neonatal infection. The use of misoprostol led to a significant reduction in the man length of labour [ +/- standard error of the mean]: 6.8 [ +/- 0.42] hours in the misoprostol group versus 8.5 [ +/- 0.60] hours in the oxtocin group. The caesarean delivery rate in the misoprotol group was 5.6% compared with 16.7% in the oxytocin group [not significantly different]. All caesarean sections were for failedstimulation of labour. Neonatal Apgar scores at 1 and 5 minutes were similar in the two group and there was no admission to the special care baby unit [SCBU]. The incidence of maternal infection was small and was the same the in the two group [2.8%]. Misoprostol vaginal tables was effective in stimulating labour in women with PROM near term. It use was associated with significantly shorter labour without significant influence on the caesarean rate or fetal-maternal infective morbidity when compared with oxytocin infusion