PP089. A new expectant management of early-onset preeclampsia

Pregnancy Hypertens. 2012 Jul;2(3):289. doi: 10.1016/j.preghy.2012.04.200. Epub 2012 Jun 13.

Abstract

Introduction: Early-onset and severe preeclampsia (PE) is a leading cause of maternal and prenatal morbidity and mortality. It has been challenging for doctors to produce good outcomes for both preeclamptic mothers and their babies.

Objectives: To ameliorate this situation, a new expectant management was introduced in this study.

Methods: Umbilical blood velocity was monitored in 10 cases of early-onset preeclampsia patients who were treated continuously with magnesium sulfate accordingly.

Results: The average gestational age when PE initiated was 28±3 weeks (ranging from 23 to 31weeks). The mean days prolonged by expectant management were 32.5±23.6 days (ranging from 8 to 95days). The average gestational age at delivery was 34±1weeks (ranging from 31(+3) to 37weeks). The mean amount of magnesium sulfate used was 310.5±252.3g (ranging from 70 to 1000g). 10 pregnant women were all with abnormal umbilical blood velocity when admitted. All 10 babies were born alive. The mean birth weight was 1848±669g (ranging from 900 to 3120g). 9 (90%) babies were premature, and 6 (60%) babies had intrauterine growth restriction. There was no mortality or morbidity in both mothers and newborns.

Conclusion: Early-onset preeclampsia is a process of stress injuries directly caused by feta-placental ischemia, which could be monitored by measuring the umbilical blood velocity by Doppler Ultrasound. Continuous use of magnesium sulfate may better maternal and prenatal outcomes by dilating placental blood vessels and increasing the umbilical blood.