Outcomes in Expectant Management for Patients with Preeclampsia with Severe Features

Purpose: This study aims to evaluate the outcomes of expectant management of preeclampsia with severe features compared to immediate delivery. Methods: Immediate delivery included anyone at or before steroid benefit ( 48 hours). Retrospective chart review was conducted to identify patients diagnosed with preeclampsia with severe features at a large urban medical center from 2014 to 2020. Patients diagnosed after 34 weeks gestational age were excluded, as ACOG guidelines universally recommend delivery over expectant management for those individuals. Demographic data was collected including age, race, parity, marital status, and insurance type. Preeclampsia labs on admission were also collected. Hospital stays were reviewed to determine maximum blood pressures between admission and delivery, days between diagnosis and delivery, gestational age, and whether patients were delivered vaginally or by cesarean. Postpartum blood pressure values were collected at discharge, one week, six weeks, and one year postpartum. Documentation of antihypertensive prescriptions at discharge and follow-up visits was also reviewed. Chi-squared or Fisher’s exact test was used to compare categorical variables while t test was used for continuous variables. Data were log transformed to meet parametric assumptions and geometric mean (GM) was reported. A two-sided p-value