Impact of Early-Onset Severe Pre-eclampsia on Maternal and Perinatal Outcomes: Evaluating the Role of Expectant Management – A Prospective Observational Study (Code: T0005)
Keywords:
Early-onset severe pre-eclampsia, Expectant management, Maternal outcomes, Neonatal survival, Perinatal morbidity, Hypertensive disorders of pregnancy.Synopsis
Introduction
Early-onset severe pre-eclampsia (EOSPE) is a critical condition characterized by severe hypertension and multisystemic involvement before 32 weeks of gestation. It poses significant risks to both maternal and neonatal health, often requiring meticulous management to balance maternal safety and fetal viability. This study evaluates the impact of expectant versus immediate management on maternal and neonatal outcomes in cases of EOSPE.
AIM OF THE STUDY
To compare rate of infection in open reduction and internal fixation and minimally invasive plate osteosynthesis (MIPO) in closed femur and tibia fractures.
Methods
A prospective observational study was conducted from February 2022 to April 2023 at Mysore Medical College and Research Institute. Women diagnosed with EOSPE based on ACOG 2019 criteria before 32 weeks of gestation were included. Expectant management, defined as the deliberate extension of pregnancy by 72 hours post-admission where clinically feasible, was compared with immediate delivery. Maternal complications, neonatal survival, birth weights, and APGAR scores were assessed. Statistical analysis was performed using SPSS version 29, with p<0.05 considered significant.
Results
Among 150 participants, expectant management was associated with higher neonatal birth weights (mean 512.34 ± 275.87 g vs. 345.12 ± 280.15 g, p<0.05) and improved APGAR scores. Neonatal survival rates were significantly better in the expectant group (40% vs. 25%). Maternal complications, including eclampsia and HELLP syndrome, were comparable between groups. Outcomes improved markedly when pregnancies were prolonged beyond 28 weeks of gestation.
Conclusion
Expectant management in EOSPE cases improves neonatal outcomes, particularly when pregnancies are extended beyond 28 weeks, without increasing maternal risks. Early termination remains critical for cases before 28 weeks due to the heightened risk of maternal and perinatal complications. Individualized care and shared decision-making are essential in optimizing outcomes for both mother and neonate.
