[Severe preeclampsia: management. Is conservative treatment justified?]

P Merviel, A Dumont, J P Bonnardot, J F Perier, E Rondeau, N Berkane, J Salat-Baroux, S Uzan
Journal de Gynécologie, Obstétrique et Biologie de la Reproduction 1997, 26 (3): 238-49
Severe preeclampsia is a major contributor to maternal and perinatal morbidity and mortality. This review was performed to assess the fetal and maternal benefits of allowing women presenting with severe preeclampsia between 24 and 32-34 weeks of amenorrhea to continue their pregnancy following antihypertensive treatment. After ultrasound scanning to assess growth and biophysical state of the fetus, patients without deteriorating maternal conditions, were managed with volume expansion, antihypertensive drugs (as hydralazine, labetalol, nifedipine), anticonvulsants and prophylactic steroids to promote fetal pulmonary maturity. Previous studies have indicated that this conservative management is also possible with the HELLP syndrome, without an increase in maternal morbidity.

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