PREGNANCY OUTCOME IN 303 CASES WITH SEVERE PREECLAMPSIA

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  • 1 January 1984
    • journal article
    • research article
    • Vol. 64  (3) , 319-325
Abstract
To determine the influence of aggressive management, associated medical/obstetric complications, race and gestational age on fetal, neonatal and maternal risks associated with severe preeclampsia, 303 consecutive pregnancies complicated by severe preeclampsia were studied. All patients were delivered within 48 h after admission to the perinatal center. In 91 patients the disease was superimposed on chronic hypertension. There was a significant difference between patients with and those without prior chronic hypertension regarding perinatal mortality (32 vs. 7.7%), incidence of abruptio placentae (10 vs. 4%), and frequency of small-for-gestational-age infants (33 vs. 14%). Patients (51) (17%) had thrombocytopenia, 26 (8.5%) had hemolysis, elevated liver enzymes and low platelet count syndrome and 22 (7.3%) had disseminated intravascular coagulopathy. There was a significant difference between white and black patients regarding the frequency of thrombocytopenia (28 vs. 13%), hemolysis, elevated liver enzymes, and low platelet count syndrome (19.7 vs. 5.3%), and coagulopathy (13 vs. 1.4%). However, most of this apparent racial difference resulted from higher incidence of abnormal hematologic findings among patients who had conservative management by private physicians before transfer. Perinatal survival was 0 when severe preeclampsia developed at or before 28 wk, whereas it was 100% when disease developed after 36 wk gestation. The above factors should be considered in counseling patients with severe preeclampsia.