%0 Observational Study
%T Maternal and perinatal outcome of women with early-onset severe pre-eclampsia before 28 weeks: Is expectant management beneficial in a low-resource country? A prospective observational study.
%A Gangadhar L
%A Rengaraj S
%A Thiyagalingam S
%A Bethou A
%J Int J Gynaecol Obstet
%V 161
%N 3
%D Jun 2023 29
%M 36582144
%F 4.447
%R 10.1002/ijgo.14642
%X <B>OBJECTIVE: </B>To study the maternal and perinatal outcomes in women with severe pre-eclampsia before 28 weeks of pregnancy.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.