Mild Preeclampsia Near Term: Deliver or Deliberate?
Mild Preeclampsia Near Term: Deliver or Deliberate?
Preeclampsia with new-onset hypertension and proteinuria is a pregnancy-specific disease that
 affects 5-7% of gestations usually after the 20th week. Most cases are mild, but severe cases
 exhibit multiple abnormalities in blood and maternal organ systems. Severe forms of
 preeclampsia/eclampsia are a major contributor to maternal death in the world. Delivery stops
 disease progression and recovery can begin. Patients with mild preeclampsia between 34-38
 weeks' gestation usually are hospitalized for evaluation and close monitoring of signs,
 symptoms, and certain laboratory studies as reflectors of disease status. As inpatients
 mothers are monitored frequently for evidence of maternal or fetal compromise until 38 weeks
 gestation when delivery is accomplished. If a patient with mild preeclampsia labors after 34
 weeks, no attempt is made to stop labor and delivery is undertaken. It remains unclear when
 during the third trimester that delivery should be accomplished for maximal maternal safety
 and minimal fetal risk. In this research project, we will identify patients who are at least
 34 weeks pregnant with mild preeclampsia. After informed consent to participate in the trial,
 we will randomize participants to either be delivered immediately or treated with observation
 and maternal-fetal surveillance in hospital as described previously with delivery at 38
 weeks. There will be 110 participants enrolled in each arm of the study for a total of 220
 patients who will be managed in the Wiser Hospital. We intend to analyze a number of maternal
 and fetal outcomes including cost comparisons for the care of both mother and fetus in the
 two groups of randomized patients. The findings should impact care of the pregnant patient
 with mild preeclampsia in the third trimester with regard to how early and how late in
 gestation that delivery should be accomplished for optimal maternal and perinatal benefit.
Inclusion Criteria:

 -  Mild Preeclampsia equal to or greater than 34 weeks' and less that 38 weeks' gestation
 singleton gestation no maternal or fetal contraindications to conservative management

 Exclusion Criteria:

 -  Non-gestational diabetes Chronic hypertension Severe preeclampsia Non-reassuring fetal
 assessment intrauterine growth restriction fetal anomalies multiple gestation
 premature preterm rupture of membranes placenta previa unexplained vaginal bleeding
 antihypertensive use current gestation poor dating criteria contraindication to
 conservative management active labor at admission