Outcome Differences Between Women With Superimposed Preeclampsia With and Without Severe Features [28Q]

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Abstract

INTRODUCTION:

The Hypertension in Pregnancy Task Force (2013) divided the diagnosis of superimposed preeclampsia into two categories: with and without severe features. This study compares obstetric outcomes in women with superimposed preeclampsia with and without severe features based on this new diagnostic criteria.

METHODS:

Women with singletons and chronic hypertension with superimposed preeclampsia with and without severe features who delivered between January 2008 and July 2015 at a university hospital were identified based on diagnostic criteria in the Hypertension in Pregnancy Task Force (2013). Primary outcome assessed was composite maternal morbidity, including placental abruption, maternal ICU admission, eclampsia, HELLP syndrome and death. Secondary outcomes included gestational age (GA) at delivery, GA at diagnosis, small for GA, birth weight, 5-minute Apgar less than 7, NICU admission, and IUFD. Chi-square and student t test were used as appropriate.

RESULTS:

135 pregnancies with severe features and 66 without severe features were identified. Both groups were similar in maternal demographics. There was no difference in the composite maternal morbidity (P=1.0). Women with severe features were delivered earlier (P=.004), had smaller neonates (P=.01), shorter latency from diagnosis to delivery (P=.03), and higher incidence of IUFD (P=.03). Women diagnosed with severe features solely by BP criteria had a significantly higher IUFD rate than the non-severe group (P=.009).

CONCLUSION:

Women with superimposed preeclampsia and severe features have significantly higher risk of perinatal complications, especially for IUFD. These women warrant intense surveillance.

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