Early, planned delivery for women with pre-term pre-eclampsia decreases complications and severe hypertension, as well as costs, compared to the current method of care, reports a new study. The findings of the study are published in the journal The Lancet. The team from the Department of Women & Children's Health at King's carried out a trial comparing the current and new methods in women suffering from pre-eclampsia at 34-37 weeks of pregnancy, to see if they could reduce adverse outcomes for the mother such as hypertension, and without impacting substantially on the baby.
They also found that the women in that group had more vaginal deliveries compared to those who experience the current method of care - specialist assessment of mother and unborn baby until 37 weeks, with delivery sooner if the clinical scenario changes and there is concern over severe pre-eclampsia and associated complications.
Though planned delivery did lead to more neonatal unit admissions for prematurity, there were no other complications for the baby (such as more breathing problems) compared to the current method. Planned delivery also comes with lower costs compared to the current method of care in the UK.
Pre-eclampsia is a condition that affects around 1 in 20 pregnant women, usually during the second half of pregnancy, affecting approximately 40,000 women annually in the UK. If untreated, it can progress to cause complications in the woman, including damage to vital organs, fits and can be fatal for the woman and baby. Globally, 100 women die as a result of the condition every day.
Current guidelines recommend prompt delivery after 37 weeks of pregnancy. However, for women with late pre-term pre-eclampsia (defined as 34-37 weeks pregnant) the recommendations are less clear.
"Our trial supports offering initiation of delivery in women with late pre-term pre-eclampsia. Doctors and women will need to consider the trade-off between lower maternal complications and severe hypertension against more neonatal unit admissions, but the trial results tell us that these babies were not sicker from being born earlier. We suggest that these results should be discussed with women with late pre-term pre-eclampsia to allow shared decision making on the timing of delivery."