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Maternal and neonatal outcomes in women with severe early onset pre-eclampsia before 26 weeks of gestation, a case series
- Source :
- BJOG : An International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley, BJOG : an International Journal of Obstetrics and Gynaecology, 124, 1440-1447, Bjog-An International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley-Blackwell Publishing Ltd, van Oostwaard, M F, van Eerden, L, de Laat, M W, Duvekot, J J, Erwich, J J H M, Bloemenkamp, K W M, Bolte, A C, Bosma, J P F, Koenen, S V, Kornelisse, R F, Rethans, B, van Runnard Heimel, P, Scheepers, H C J, Ganzevoort, W, Mol, B W J, de Groot, C J & Gaugler-Senden, I P M 2017, ' Maternal and neonatal outcomes in women with severe early onset pre-eclampsia before 26 weeks of gestation, a case series ', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 124, no. 9, pp. 1440-1447 . https://doi.org/10.1111/1471-0528.14512, Bjog-an International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley, BJOG : an International Journal of Obstetrics and Gynaecology, 124, 9, pp. 1440-1447, BJOG: An International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley Online Library, BJOG, 124(9), 1440-1447. Wiley-Blackwell, BJOG-An International Journal of Obstetrics and Gynaecology, 124(9), 1440. Wiley-Blackwell
- Publication Year :
- 2017
-
Abstract
- Item does not contain fulltext OBJECTIVE: To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation. DESIGN: Nationwide case series. SETTING: All Dutch tertiary perinatal care centres. POPULATION: All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014. METHODS: Women were identified through computerised hospital databases. Data were collected from medical records. MAIN OUTCOME MEASURES: Maternal complications [HELLP (haemolysis, elevated liver enzyme levels, and low platelet levels) syndrome, eclampsia, pulmonary oedema, cerebrovascular incidents, hepatic capsular rupture, placenta abruption, renal failure, and maternal death], neonatal survival and complications (intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis, bronchopulmonary dysplasia, and sepsis), and outcome of subsequent pregnancies (recurrent pre-eclampsia, premature delivery, and neonatal survival). RESULTS: We studied 133 women, delivering 140 children. Maternal complications occurred frequently (54%). Deterioration of HELLP syndrome during expectant care occurred in 48%, after 4 days. Median prolongation was 5 days (range: 0-25 days). Neonatal survival was poor (19%), and was worse (6.6%) if the mother was admitted before 24 weeks of gestation. Complications occurred frequently among survivors (84%). After active support, neonatal survival was comparable with the survival of spontaneous premature neonates (54%). Pre-eclampsia recurred in 31%, at a mean gestational age of 32 weeks and 6 days. CONCLUSIONS: Considering the limits of prolongation, women need to be counselled carefully, weighing the high risk for maternal complications versus limited neonatal survival and/or extreme prematurity and its sequelae. The positive prospects regarding maternal and neonatal outcome in future pregnancies can supplement counselling. TWEETABLE ABSTRACT: Severe early onset pre-eclampsia comes with high maternal complication rates and poor neonatal survival.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pediatrics
severe pre-eclampsia
HELLP syndrome
Population
Gestational Age
prolongation
Severity of Illness Index
Infant, Newborn, Diseases
03 medical and health sciences
0302 clinical medicine
Pre-Eclampsia
Pregnancy
medicine
Journal Article
Humans
030212 general & internal medicine
education
Maternal and neonatal outcome
Netherlands
Retrospective Studies
education.field_of_study
030219 obstetrics & reproductive medicine
Eclampsia
business.industry
Obstetrics
Other Research Radboud Institute for Health Sciences [Radboudumc 0]
Infant, Newborn
Pregnancy Outcome
Obstetrics and Gynecology
Gestational age
preterm birth
Retinopathy of prematurity
medicine.disease
Prognosis
Bronchopulmonary dysplasia
Pregnancy Trimester, Second
Maternal death
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 14700328
- Database :
- OpenAIRE
- Journal :
- BJOG : An International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley, BJOG : an International Journal of Obstetrics and Gynaecology, 124, 1440-1447, Bjog-An International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley-Blackwell Publishing Ltd, van Oostwaard, M F, van Eerden, L, de Laat, M W, Duvekot, J J, Erwich, J J H M, Bloemenkamp, K W M, Bolte, A C, Bosma, J P F, Koenen, S V, Kornelisse, R F, Rethans, B, van Runnard Heimel, P, Scheepers, H C J, Ganzevoort, W, Mol, B W J, de Groot, C J & Gaugler-Senden, I P M 2017, ' Maternal and neonatal outcomes in women with severe early onset pre-eclampsia before 26 weeks of gestation, a case series ', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 124, no. 9, pp. 1440-1447 . https://doi.org/10.1111/1471-0528.14512, Bjog-an International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley, BJOG : an International Journal of Obstetrics and Gynaecology, 124, 9, pp. 1440-1447, BJOG: An International Journal of Obstetrics and Gynaecology, 124(9), 1440-1447. Wiley Online Library, BJOG, 124(9), 1440-1447. Wiley-Blackwell, BJOG-An International Journal of Obstetrics and Gynaecology, 124(9), 1440. Wiley-Blackwell
- Accession number :
- edsair.doi.dedup.....0f2d78cbe6d9e39ca4b73a0c29690285