Management of late preterm preeclampsia: a comparison of maternal and fetal indications for delivery.

Objective: To investigate delivery indications for women with late preterm preeclampsia and evaluate whether disease characteristics at presentation are predictive of delivery indication.

Methods: We conducted a retrospective case-control study at the Mercy Hospital for Women (a tertiary hospital in Melbourne, Australia). Indication for delivery was assessed among women presenting with preeclampsia between 30⁺⁰ and 36⁺⁰ weeks' gestation. Baseline maternal and disease characteristics, preeclampsia features at delivery and postnatal outcomes were compared between patients delivering for maternal, fetal, or for both maternal and fetal indications.

Results: 173 women were diagnosed with preeclampsia between 30⁺⁰ and 36⁺⁰ weeks' gestation. Maternal baseline characteristics were similar between the groups. We found that 55.5% of women were delivered on maternal grounds compared to 27.2% requiring delivery for fetal indications; and 17.3% for both maternal and fetal indications (p < .0001). At diagnosis, intrauterine growth restriction and abnormal Dopplers increased the risk of requiring delivery for fetal indications by 3.5 times and 2.4 times respectively.

Conclusion: Women presenting with late preterm preeclampsia primarily required delivery for maternal disease progression rather than fetal compromise.