| Excerpt from The WHO Reproductive Health Library | Published by Update Software Ltd. |
The review compares the effects of a policy of interventionist care and early delivery with a policy of expectant care and delayed delivery for women with early onset of severe pre-eclampsia. The main objective of expectant management is to allow the baby more time in utero so that the risk of respiratory distress syndrome or other complications due to prematurity could be reduced. There are only two trials (totalling 133 women) included in the review, one conducted in the USA and the other in South Africa.
In the group subjected to interventionist care there was a greater incidence of hyaline membrane disease, necrotising enterocolitis and admission to intensive care compared with the expectant care group. However, fewer babies in the interventionist care group were small for gestational age. The included trials are small so the data are insufficient to draw any reliable conclusions about substantive outcomes related to maternal morbidity or mortality or perinatal morbidity or mortality.
The authors conclude that there are insufficient data to make recommendations regarding the best policy with regard to early onset of severe pre-eclampsia and that more trials with appropriate size and end points are needed.
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