Analysis Of Expectant Management On Early Onset Severe Pre-eclampsia

Objective:To investigate the effect of the expectant management on the maternal and fetal outcome of women who with early onset severe pre-eclampsia in different gestational weeks.Methods:The clinical data of 48 patients with early onset of severe preeclampsia1 in the first affiliated hospital of Dalian Medical University from January 2000 to December 2008 were retrospective study. Patients were divided into 3 groups: group A(n = 6) with onset before 28 weeks of gestation, group B ( n =22) with onset during28-31+6 weeks of gestation, group C (n = 20) with onset during32-33+6 gestational weeks, At the same time randomly selected the clinical data of 30 patients with late-onset (with onset during34-39+6 gestational weeks) severe preeclampsia1 hospitalized in the same period as contrast group for comparison-- group D (n = 30).Main outcome measures included prolongation of gestation, perinatal mortality rate, and fatal growth restriction as well as major complications.Results:There was no significant difference in ages, gravidity among the four groups. The Contractive blood pressure and diastolic blood pressure in group A,B were higher than group C,D, therefore, there was no significant difference among group A,B and C,D. The urine protein in group A,B,C were higher than group D, there was no significant difference among group A,B and C. The complications ratio in group A was higher than group B,C,D, but there was no significant difference among group B,C,D. The average pregnancy prolongation was(5±2)d, (10±4)d, (9±6)d, and(4±2)d, respectively in groups A,B,C and D. The average pregnancy prolongation in group B,C was longer than group A,D, there was no significant difference among group B,C and A,D, there was no significant difference in FGR rate among the four groups either. The still-birth ratio of group A was significant higher than group B,C,D.Conclusions:Compared with the LS-PE group, The ES-PE group was early onset and severe, with many gestational complications, uncontrolled hypertension and the urine protein appeared earlier and higher. Expectant management was safe to the mothers by well selecting patients, monitoring accurately and terminating pregnancies on time. The pregnancies should be ended on time when severe complications happened and threatened the maternal and fetal lives,cesarean was preferences if the fatal was viable. Expectant management on early onset severe pre-eclampsia should be taken actively in 28-33+6 gestational weeks, and with caution in less than 28 gestational weeks.