Clinical trial of expectant management of severe preeclampsia that develops at <32 weeks' gestation at a Japanese perinatal center.

OBJECTIVE: This study was to examine the clinical usefulness of expectant management of early-onset severe preeclampsia.

METHODS: We reviewed the obstetric records of all Japanese singleton deliveries at ≥22 weeks' gestation managed at Japanese Red Cross Katsushika Maternity Hospital between 2007 and 2012. We compared the obstetric characteristics and perinatal outcomes between the cases of deliveries before (n = 19) and after completion of corticosteroids (n = 30) (immediate delivery versus expectant management).

RESULTS: Although the gestational age at delivery in the patients expectantly managed was higher than that in the patients required immediate deliveries (31.0 versus 29.3 weeks), the difference in the incidence of neonatal respiratory distress syndrome between the two groups did not reach the statistical significance (74 versus 47%, p = 0.06). The incidence of pulmonary edema in the patients expectantly managed was significantly higher than that in the patients required immediate deliveries within the first 48 h (20 versus 0%, p = 0.04).

CONCLUSION: The current results could not support the clinical usefulness of expectant management of early-onset severe preeclampsia.