What are the delivery criteria for severe preeclampsia managed expectantly?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Answer

Women with severe preeclampsia who are managed expectantly must be delivered under the following circumstances:

  • Nonreassuring fetal testing including nonreassuring nonstress test, biophysical profile score, and/or persistent absent or reversed diastolic flow on umbilical artery Doppler velocimetry

  • Ruptured membranes

  • Uncontrollable BP (unresponsive to medical therapy)

  • Oligohydramnios, with amniotic fluid index (AFI) of less than 5 cm

  • Severe intrauterine growth restriction in which the estimated fetal weight is less than 5%

  • Oliguria (< 500 mL/24 hours)

  • Serum creatinine level of at least 1.5 mg/dL

  • Pulmonary edema

  • Shortness of breath or chest pain with pulse oximetry of < 94% on room air

  • Headache that is persistent and severe

  • Right upper quadrant tenderness

  • Development of HELLP (hemolysis, elevated liver enzyme, low platelets) syndrome

  • Eclampsia

  • Platelet count less than 100,000/μL

  • Placental abruption

  • Unexplained coagulopathy


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