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

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

Acknowledgements

We would like to thank the participants from the Mercy Hospital for Women for taking part in this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

FB was supported by a National Health and Medical Research Council Early Career Fellowship [NHMRC #1142636] and a Norman Beischer Medical Research Foundation grant. The funders had no role in study design, data collection, analysis, decision to publish or the preparation of the manuscript.