Outcomes of expectant management after betamethasone for hypertensive disorders of pregnancy

Abstract

Objective: Review the latency period after betamethasone (BMZ) for pregnancies complicated by hypertensive disorders of pregnancy (HDP). Study design: A retrospective chart review of patients that received BMZ for the reduction of preterm morbidity for HDP. Patients were grouped by gestational age of administration of BMZ and type of hypertensive disorder of pregnancy for analysis. The primary outcome was the interval between the gestational age of the patient at BMZ administration and delivery. Results: One-hundred and forty-seven subjects received BMZ for HDP during the study period delivering 168 infants. The median interval between administration of BMZ and delivery was 5 days [interquartile range (IQR) 2–20 days]. The median neonatal intensive care unit length of stay (NICU LOS) was 20 days (IQR 6–33 days). Fifty-seven percent of subjects delivered within 7 days of diagnosis and 32% had a latency period >14 days. Seventy-five percent of subjects were ultimately delivered for worsening hypertension. Conclusions: The median latency period between diagnosis and delivery in the setting of HDP is <7 days. Further studies are warranted to address the use of antihypertensive pharmacotherapy to prolong the latency period for fetal benefit.

• Gestational hypertension
• hypertension
• pre-eclampsia
• pregnancy

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. The source of the work is from the electronic medical records at Northwestern Memorial Hospital. These findings were presented at the 33rd Annual Meeting of the Society for Maternal Fetal Medicine in February 2013 in San Francisco, CA, USA.