In the findings of the PHOENIX trial published this week in The Lancet, researchers from King's College London have found that early, planned delivery for women with preterm pre-eclampsia reduces complications and severe hypertension, as well as costs, compared with the current method of care.
The team carried out a trial comparing the current and new methods in women suffering from pre-eclampsia at 34 to
They found that starting delivery either by induction or caesarean section within 48 hours of the diagnosis of preterm pre-eclampsia reduced maternal complications including hypertension. They also found that these women had more vaginal deliveries compared with those receiving the current method of care - specialist assessment of mother and unborn baby until 37 weeks, with delivery sooner if the clinical scenario changes and there is concern over severe pre-eclampsia and associated complications.
Though planned delivery did lead to more neonatal unit admissions for prematurity, there were no other complications for the baby compared with the current method. Planned delivery also comes with lower costs compared with the current method of care in the UK.
Lead author Professor Lucy Chappell from King's College London said: "Our trial supports offering initiation of delivery in women with late preterm pre-eclampsia. Doctors and women will need to consider the trade-off between lower maternal complications and severe hypertension against more neonatal unit admissions, but the trial results tell us that these babies were not sicker from being born earlier. We suggest that these results should be discussed with women with late preterm pre-eclampsia to allow shared decision making on timing of delivery."