Comparison of two management strategies for preeclampsia/superimposed preeclampsia: a single-center retrospective cohort study

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  • Nakashima Natsumi
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Sakai Atsuhiko
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Kamura Shunsuke
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Hachisuga Nobutaka
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Sugitani Maiko
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Hara Emiko
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Kido Saki
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Ogawa Masanobu
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Fujita Yasuyuki
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University
  • Kato Kiyoko
    Department of Gynecology and Obstetrics, Graduate School of Medical Sciences, Kyushu University

Description

<p>This retrospective cohort study aimed to determine a better management strategy for patients with preterm preeclampsia/superimposed preeclampsia (PE/SPE). Thirty-six women with PE/SPE and their neonates managed from January 2018 to March 2019 (Period 1: P1), and 53 women with PE/SPE and their neonates managed from October 2019 to March 2021 (Period 2: P2), were enrolled. Antihypertensive therapy was initiated when blood pressure increased to ≥160/110 mmHg and ≥140/90 mmHg in P1 and P2, respectively. During P1, pregnancies beyond 34 weeks of gestation with severe features were terminated without exception. During P2, pregnancies were maintained to 37 weeks of gestation. Maternal and neonatal outcomes were compared between the two groups, with the main outcome measures being the incidences of composite adverse maternal outcomes and composite adverse neonatal outcomes. Gestational weeks of delivery were significantly prolonged in P2 than in P1. The incidence of composite adverse maternal outcomes was comparable between the two groups. The incidence of composite adverse neonatal outcomes was significantly lower, and the duration of NICU stay significantly shorter, in P2 than in P1. In conclusion, aggressive antihypertensive therapy with cautious observation can prolong pregnancy and may benefit neonates born to mothers with PE/SPE.</p>

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