Comparación de dos protocolos de manejo en preeclampsia severa lejos del término, y resultados maternos y neonatales: Una cohorte histórica hospital universitario San José, Popayán (Colombia)

Abstract

Objective: To determine if there is a difference in safety using expectant or active management for patients with less than 34 weeks of gestation and severe preeclampsia, in terms of maternal and foetal outcomes. Materials and methods: Historic cohort of pregnant women between 24 and 34 weeks of gestation diagnosed with severe preeclampsia, managed in accordance with an expectant or an active protocol after a course of steroids, based on the judgment of the team in charge at a referral teaching hospital in the southwest of Colombia. Consecutive sampling. The primary endpoints measured were maternal mortality and complications, and a composite measurement of poor maternal outcomes. Secondary endpoints measured were neonatal mortality, length of stay in the neonatal intensive care unit (NICU) and hours of mechanical ventilation, as well as a composite measurement of neonatal complications. Baseline and clinical characteristics of the two populations were measured, as well as neonatal outcomes, using the exact Fisher test or the chi square test for categorical variables, and non-parametric tests for continuous variables. Results: The groups were comparable in terms of their baseline characteristics. Pregnancy prolongation with expectant management was in average 8.8 days ± 8.74 days SD. There were no statistical differences between the two protocols regarding maternal or perinatal morbidity and mortality during the postpartum period, neonatal length of stay, or mechanical ventilation hours (p > 0.05). Conclusion: No advantages were found in terms of safety maternal and foetal outcomes when comparing expectant and active management of patients with early severe preeclampsia.