Severe preterm preeclampsia: Aggressive or expectant management?

ABSTRACT

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