Abstract：
OBJECTIVE: To study the maternal and perinatal outcomes in women with severe pre-eclampsia before 28 weeks of pregnancy.
METHODS: A descriptive study from a tertiary care center. All consecutive women with severe pre-eclampsia withonset before 28 weeks of pregnancy were included. The details were collected in a predesigned structured proforma prospectively.
RESULTS: The study cohort included 145 women with a mean maternal age of 26.97 ± 5.36 years (range 19-47 years). The mean duration of prolongation of pregnancy was 13.04 ± 10.57 days (range 1-51 days). A total of 29.7% (n = 43) of women had at least one major adverse maternal outcome, and the most common was HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome (n = 24,16.6%), followed by eclampsia (n = 12,8.3%). The stillbirth rate was high (n = 103,68.7%), and most occurred in the antepartum period. Of 47 (31.3%) neonates born alive, only eight (17.02%;8/47) survived up to 28 days of life. Fetal growth restriction with Doppler abnormalities and neonatal sepsis were the most common reasons for perinatal mortality.
CONCLUSIONS: Expectant management should not be considered routinely when the onset of severe pre-eclampsia is before 25+6 weeks of pregnancy. Between 26 and 27+6 weeks it can be offered under close monitoring and the perinatal survival depends on the neonatal services available in their facility.
METHODS: A descriptive study from a tertiary care center. All consecutive women with severe pre-eclampsia withonset before 28 weeks of pregnancy were included. The details were collected in a predesigned structured proforma prospectively.
RESULTS: The study cohort included 145 women with a mean maternal age of 26.97 ± 5.36 years (range 19-47 years). The mean duration of prolongation of pregnancy was 13.04 ± 10.57 days (range 1-51 days). A total of 29.7% (n = 43) of women had at least one major adverse maternal outcome, and the most common was HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome (n = 24,16.6%), followed by eclampsia (n = 12,8.3%). The stillbirth rate was high (n = 103,68.7%), and most occurred in the antepartum period. Of 47 (31.3%) neonates born alive, only eight (17.02%;8/47) survived up to 28 days of life. Fetal growth restriction with Doppler abnormalities and neonatal sepsis were the most common reasons for perinatal mortality.
CONCLUSIONS: Expectant management should not be considered routinely when the onset of severe pre-eclampsia is before 25+6 weeks of pregnancy. Between 26 and 27+6 weeks it can be offered under close monitoring and the perinatal survival depends on the neonatal services available in their facility.
摘要：
目的：目的是研究妊娠28周前重度先兆子痫妇女的母婴结局。
方法：来自三级护理中心的描述性研究。包括所有在妊娠28周前发病的重度先兆子痫（PE）的连续妇女。细节是在预先设计的结构化形式中收集的。
结果：该研究队列包括145名妇女，平均孕产妇年龄为26.97岁±5.36（19-47）。延长妊娠的平均持续时间为13.04天±10.57（1-51天）。共有29.7%的妇女有至少一种主要的不良产妇结局,最常见的是HELLP综合征（16.6%），其次是子痫(8.3%)。死胎率高(68.7%),大多数发生在产前。在47个活着出生的婴儿中，只有八个婴儿存活到28天。FGR伴多普勒异常和新生儿败血症是围产期死亡的常见原因。
结论：当重度PE发病在25+6周时，不应常规考虑预期治疗。在26-27+6周之间，可以在密切监测下提供，围产期存活取决于其设施中提供的新生儿服务。
方法：来自三级护理中心的描述性研究。包括所有在妊娠28周前发病的重度先兆子痫（PE）的连续妇女。细节是在预先设计的结构化形式中收集的。
结果：该研究队列包括145名妇女，平均孕产妇年龄为26.97岁±5.36（19-47）。延长妊娠的平均持续时间为13.04天±10.57（1-51天）。共有29.7%的妇女有至少一种主要的不良产妇结局,最常见的是HELLP综合征（16.6%），其次是子痫(8.3%)。死胎率高(68.7%),大多数发生在产前。在47个活着出生的婴儿中，只有八个婴儿存活到28天。FGR伴多普勒异常和新生儿败血症是围产期死亡的常见原因。
结论：当重度PE发病在25+6周时，不应常规考虑预期治疗。在26-27+6周之间，可以在密切监测下提供，围产期存活取决于其设施中提供的新生儿服务。
