Expectant management of early onset, severe pre-eclampsia: maternal outcome

BJOG. 2000 Oct;107(10):1252-7. doi: 10.1111/j.1471-0528.2000.tb11616.x.


Objective: To evaluate the safety and outcome of women undergoing expectant management of early onset, severe pre-eclampsia.

Design: Prospective case series extending over a five-year period.

Setting: Tygerberg Hospital, a tertiary referral centre.

Population: All women (n = 340) presenting with early onset, severe pre-eclampsia, where both the mother and the fetus were otherwise stable.

Methods: Frequent clinical and biochemical monitoring of maternal status, together with careful blood pressure control, in a high care obstetric ward.

Main outcome measures: Major maternal complications and prolongation of gestation.

Results: Multigravid women constituted 67% of the group. Antenatal biochemistry was reassuring with some expected, but not severe, deteriorations. Twenty-seven percent of women experienced a major complication, but few had poor outcomes. No maternal deaths occurred. Most major complications resolved quickly, necessitating only three admissions (0.8%) to the intensive care unit. One woman required dialysis. Pregnancies were prolonged by a mean (median) number of 11 days (9) before delivery, with more time being gained at earlier gestations. The postpartum inpatient stay (89% < or =7 days, bearing in mind that 82% of women were delivered by caesarean section) was not extended.

Conclusion: Careful noninvasive management of early onset, severe pre-eclampsia in a tertiary centre can diminish and limit the impact of serious maternal complications. Valuable time to prolong the pregnancy and improve neonatal outcome is thereby gained.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antihypertensive Agents / therapeutic use
  • Calcium Channel Blockers / therapeutic use
  • Dihydralazine / therapeutic use
  • Female
  • Fetal Distress
  • Humans
  • Magnesium Sulfate / therapeutic use
  • Methyldopa / therapeutic use
  • Monitoring, Physiologic / methods
  • Nifedipine / therapeutic use
  • Prazosin / therapeutic use
  • Pre-Eclampsia / therapy*
  • Pregnancy
  • Pregnancy Outcome
  • Prospective Studies


  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Methyldopa
  • Magnesium Sulfate
  • Nifedipine
  • Dihydralazine
  • Prazosin