Conservative management of early-onset severe preeclampsia: comparison between randomized and observational studies a systematic review.
J Matern Fetal Neonatal Med
; 35(16): 3182-3189, 2022 Aug.
Article
em En
| MEDLINE
| ID: mdl-32912001
ABSTRACT
OBJECTIVE:
To compare maternal and perinatal outcomes between randomized trials and observational studies in which conservative management was performed for more than 48 h in patients with early-onset severe preeclampsia.METHODOLOGY:
We searched PubMed, LILACS, Cochrane and Google Scholar. The studies were divided in two groups randomized and observational studies, from 1990 to 2018 that included patients with severe preeclampsia before 34 weeks of gestation with pregnancy prolongation ≥48 h but that did not include fetal growth restriction or HELLP syndrome at the beginning. The main variables recorded were maternal and perinatal complications. MAINRESULTS:
Forty-four studies met the inclusion criteria, and 5 of these were randomized. The average pregnancy prolongation was 9 days, with no difference between groups. Maternal complications were significantly more common in observational studies, RR = 0.71, 95% CI (0.54-0.93), p = .009. Perinatal complications were also significantly more common in observational studies (RR = 0.89, 95% CI (0.80-0.98), p = .01) at the expense of stillbirth and neonatal deaths. The percentages of cesarean sections were significantly higher in randomized studies, RR = 1.54, 95% CI (1.46-1.64). There were 2 maternal deaths, both in observational studies.CONCLUSION:
Observational studies in which conservative management of early-onset preeclampsia is performed and do not include patients with fetal growth restriction or patients with HELLP syndrome and where at least 2 days of pregnancy prolongation is achieved are associated with significantly more maternal and perinatal complications.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pré-Eclâmpsia
/
Síndrome HELLP
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Systematic_reviews
Limite:
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
J Matern Fetal Neonatal Med
Assunto da revista:
OBSTETRICIA
/
PERINATOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos