The Clinical Evaluation of Severe Preeclampsia Developing before 34 Weeks Gestation

Ha, Y O; Kim, J I

Abstract

Preeclampsia mainly develops in late pregnancies. Preeclampsia remote from term is different from preeclampsia at near term in that preeclampsia remote from term is more often associated with high maternal and perinatal mortality and morbidity, and the expectant management is more advocated than the aggressive management in severe preeclampsia remote from term. In order to study the clinical characteristics of severe preeclampsia remote from term, 56 cases with severe preeclampsia developing before 34 weeks gestation who were admitted to Department of Obstetrics and Gynecology, Keimyung University from January, 1991 to December, 1996 was retrospectively analyzed. The results were as follows: 1. Mean maternal age, mean gestational age at onset, mean gestational age at delivery, and the prolongation of gestation were 30+/-5 years, 31.1+/-3.5 weeks, 32.8+/-3.2 weeks, and median 9.8 days (0~48 days), respectively. 2. The preeclampsia was most common in the aged group ranged from 25 to 29 years and from 30 to 34 years and its incidence in the aged group was 35.7% and 35.7%. 3. The most prevalent gestational period at onset was 30~34 weeks gestation, and its incidence was 76.8%. the most prevalent gestational period at delivery was 30~34 weeks gestation, and its incidence was 57.1%. 4. In the indication for the classification of severity, persistent proteinuria > or =2+, diastolic B.P> or =110 mmHg, and fetal growth retardation were most common, it`s incidence was 91.1%, 41.1%, and 39.3%, respectively. 5. 8.9% of patients had chronic hypertension as an underlying disease. 6. Indication for delivery in the expectant management were fetal distress (26.8%), uncontrolled HBP (26.8%), FDIU (16.0%), PROM (8.9%) premature labor (7.1%), oligohydramnios (5.4%), placenta abruptio (3.6%), headache (1.8%), pulmonary edema (1.8%), etc. 7. Idiopathic respiration distress syndrome ocurred in 46.4%. 8. Mean birth weight was 1,628+/-365 gm. The birth weight ranged from 1500 to 1999 gm was most common, and its incidence was 47.5%. 9. Of 56 patients who received antihypertensive drugs, 21.4% of patients had good responses (respond to one drug), 25.0% of patients had moderate responses (respond to two drugs), 53.6% of patients had poor responses (refractive to two drugs). 10. In the mode of delivery, vaginal delivery and cesarean birth were performed in 41.1%, and 58.9% of patients, respectively.