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Federación Mexicana de Ginecología y Obstetricia, A.C.

2022, Number 02

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Ginecol Obstet Mex 2022; 90 (02)

Expectant management in severe preeclampsia: Narrative review

Vélez-Cuervo SM, Gutiérrez-Villegas LM

Language: Spanish
References: 35
Page: 165-173
PDF size: 179.95 Kb.


ABSTRACT

Background: Preeclampsia is one of the main causes of maternal and perinatal morbidity and mortality. Its definitive treatment is termination of pregnancy, although when it is performed before 34 weeks it implies risks for both. Some authors propose expectant management when the mother's condition is not entirely adverse, in order to minimize the risks to the newborn and reduce the risks to the mother. Others suggest that this approach may have a higher rate of complications and adverse outcomes for the mother and fetus.
Objective: To review the most recent literature and describe the recommendations regarding expectant management of severe preeclampsia in preterm pregnancy.
Methodology: Retrospective study carried out based on a literature search of articles published in PubMed, LILACS, Medline, Clinical trials and Google scholar; between 1994 and 2019. Articles with observational studies, case series, case-controls, literature reviews, clinical trials, systematic reviews and meta-analyses were selected.
Results: 223 articles were obtained, 188 were excluded due to duplicity, language other than English and Spanish, lack of relevance to the specific topic and those that did not have the text available. Finally, 35 articles that met the criteria and motivated the review and analysis were included.
Conclusions: The available evidence concludes that neonatal survival is related to the weeks of gestation at the time of diagnosis and those completed at the end of that process and comorbidity with intrauterine growth restriction. In all cases, the decision to terminate the pregnancy should be individualized and decided jointly by the treating team and the patient.


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