Publicação
Atitude expectante na pré-eclâmpsia moderada tardia
| Resumo: | Background: In women with mild pre-eclampsia (PE), induction of labour beyond 37 weeks’ gestation reduces maternal complications without increased rates of neonatal complications. However the optimum management for those with mild pre-eclampsia at 34 to 37 weeks remains uncertain, as induction of labour in late pre-term pregnancy might increase neonatal morbidity and mortality compared with delivery at term. Objectives: To study maternal and neonatal outcomes of expectant management of mild PE and analyzing neonatal outcomes according to the gestational week of delivery. Methods: Retrospective study, including pregnant women with late mild PE hospitalized in Serviço de Obstetrícia do Centro Hospitalar Lisboa Norte - Hospital Santa Maria, between January of 2008 and June of 2013. Expectant monitoring was adopted, with induction of labour beyond 37 weeks’ gestation. Results: 66 women were included in the study and in 17 (25,8%) mild PE progressed to severe disease. Only in 4 (6%) women a severe outcome was registered. Fourteen neonates (20,6%) were admitted to Neonatal Intensive Care Unit but there was no significant difference in neonatal outcomes between the pre-term and term groups. Conclusion: Expectant management of late onset mild PE is associated with good maternal and neonatal outcomes although a significant number of patients progress to severe disease. The management of these women should be carried out in an inpatient basis in units with relevant maternal experience and appropriate neonatal intensive care resources. |
|---|---|
| Autores principais: | Cano, Cláudia Margarida Santos Magalhães Gomes |
| Assunto: | Gravidez Pré-eclâmpsia Obstetrícia |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Background: In women with mild pre-eclampsia (PE), induction of labour beyond 37 weeks’ gestation reduces maternal complications without increased rates of neonatal complications. However the optimum management for those with mild pre-eclampsia at 34 to 37 weeks remains uncertain, as induction of labour in late pre-term pregnancy might increase neonatal morbidity and mortality compared with delivery at term. Objectives: To study maternal and neonatal outcomes of expectant management of mild PE and analyzing neonatal outcomes according to the gestational week of delivery. Methods: Retrospective study, including pregnant women with late mild PE hospitalized in Serviço de Obstetrícia do Centro Hospitalar Lisboa Norte - Hospital Santa Maria, between January of 2008 and June of 2013. Expectant monitoring was adopted, with induction of labour beyond 37 weeks’ gestation. Results: 66 women were included in the study and in 17 (25,8%) mild PE progressed to severe disease. Only in 4 (6%) women a severe outcome was registered. Fourteen neonates (20,6%) were admitted to Neonatal Intensive Care Unit but there was no significant difference in neonatal outcomes between the pre-term and term groups. Conclusion: Expectant management of late onset mild PE is associated with good maternal and neonatal outcomes although a significant number of patients progress to severe disease. The management of these women should be carried out in an inpatient basis in units with relevant maternal experience and appropriate neonatal intensive care resources. |
|---|