Principles of management

The only effective treatment of pre-eclampsia is delivery, and the principle of care is to support the mother and fetus until this has been achieved. Management dilemmas arise with early onset disease where the risk of maternal complications has to be weighed against the risks to the fetus of premature delivery. One small trial has compared pregnancy outcome in women with severe disease at less than 34 weeks gestation randomized to delivery or expectant management (with close maternal and fetal monitoring). There was a trend towards an improvement in neonatal outcome with no apparent increase in maternal complications ( Od§Qd,§aj,,,,,§L§(., 1990). However, larger randomized trials are necessary to confirm the benefit of conservative management in this group of patients.

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