Management of late preterm preeclampsia: a comparison of maternal and fetal indications for delivery

J Matern Fetal Neonatal Med. 2022 Dec;35(25):5431-5437. doi: 10.1080/14767058.2021.1882980. Epub 2021 Feb 9.

Abstract

Objective: To investigate delivery indications for women with late preterm preeclampsia and evaluate whether disease characteristics at presentation are predictive of delivery indication.

Methods: We conducted a retrospective case-control study at the Mercy Hospital for Women (a tertiary hospital in Melbourne, Australia). Indication for delivery was assessed among women presenting with preeclampsia between 30+0 and 36+0 weeks' gestation. Baseline maternal and disease characteristics, preeclampsia features at delivery and postnatal outcomes were compared between patients delivering for maternal, fetal, or for both maternal and fetal indications.

Results: 173 women were diagnosed with preeclampsia between 30+0 and 36+0 weeks' gestation. Maternal baseline characteristics were similar between the groups. We found that 55.5% of women were delivered on maternal grounds compared to 27.2% requiring delivery for fetal indications; and 17.3% for both maternal and fetal indications (p < .0001). At diagnosis, intrauterine growth restriction and abnormal Dopplers increased the risk of requiring delivery for fetal indications by 3.5 times and 2.4 times respectively.

Conclusion: Women presenting with late preterm preeclampsia primarily required delivery for maternal disease progression rather than fetal compromise.

Keywords: Preterm preeclampsia; delivery indication; fetal compromise; preeclampsia with severe features.

MeSH terms

  • Case-Control Studies
  • Female
  • Fetal Growth Retardation
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Pre-Eclampsia* / diagnosis
  • Pre-Eclampsia* / therapy
  • Pregnancy
  • Retrospective Studies