Desenlaces maternos y fetales en el manejo expectante de la preeclampsia lejos del término

Abstract

Introduction Preeclampsia is part of the spectrum of hypertensive disorders associated with pregnancy and it causes high maternal morbidity and mortality. Gestational age has been linked with severe presentations of the disease when preeclampsia occurs far from the end of pregnancy. However, nowadays exists the possibility of providing expectant management for these patients in obstetric care units of high complexity to minimize the risk of disease and mortality in extreme preterm infants. Methods We performed a cross-sectional study which included all patients with preeclampsia remote from term between 24 and 34 weeks who received expectant management between 2009 and 2012 in Clínica Orquideas. Results A total of 121 patients diagnosed with preeclampsia remote from term and received expectant management, were recruited. The average age of the patients was 29.8 years the average days of expectant management were 4 days with a median of three days. Average gestational age at admission was 30 1/7 weeks and finalization of pregnancy age was 30 5/7 weeks. 88.4% received antenatal corticosteroids. 81.6% were severe preeclampsia. The most frequent maternal outcome was Hellp Syndrome (37%) and the most frequent fetal outcome was intrauterine fetal restriction (29.5%). Discussion Expectant management of preeclampsia should be considered in any patient with preeclampsia below the 34 week to receive antenatal corticosteroid, which proved to be a protective factor for early perinatal death. No significant difference was found between the occurrence of complications and the number of days of expectant management.