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  • Immediate delivery in women with non-severe hypertensive disorders at 34–37 weeks’ gestation does not reduce maternal complications, and increases neonatal risks more than under expectant management

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Therapeutics/Prevention
Randomised controlled trial
Immediate delivery in women with non-severe hypertensive disorders at 34–37 weeks’ gestation does not reduce maternal complications, and increases neonatal risks more than under expectant management
  1. Shakila Thangaratinam
  1. Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK
  1. Correspondence to: Shakila Thangaratinam, Women's Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Yvonne Carter Building, 58 Turner Street, Whitechapel, London E1 2AB, UK; s.thangaratinam{at}qmul.ac.uk

http://dx.doi.org/10.1136/ebmed-2015-110219

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    Commentary on: Broekhuijsen K, van Baaren GJ, van Pampus MG, et al., HYPITAT-II study group. Immediate delivery versus expectant monitoring for hypertensive disorders of pregnancy between 34 and 37 weeks of gestation (HYPITAT-II): an open-label, randomised controlled trial. Lancet 2015;385:2492–501.OpenUrlCrossRefPubMed

    Context

    Women with hypertensive disorders in pregnancy, including pre-eclampsia, are at risk of maternal and fetal complications. Delivery ameliorates the disease-related risks. The definitive treatment for pre-eclampsia is delivery of the baby and placenta. In term pregnancies, at or after 37 weeks of gestation, this is achieved by planned delivery. In women with mild or moderate hypertensive disorder between 34 and 37 weeks of gestation, the timing of delivery needs to balance the maternal risks due to the worsening of the condition against the iatrogenic, prematurity-related neonatal risks of early delivery. Furthermore, there are concerns about the neurodevelopment of infants delivered in the late preterm period. Without strong evidence, current national …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.