Planned early delivery or expectant management for late preterm pre-eclampsia (PHOENIX): a randomised controlled trial

Publication date: Available online 28 August 2019Source: The LancetAuthor(s): Lucy C Chappell, Peter Brocklehurst, Marcus E Green, Rachael Hunter, Pollyanna Hardy, Edmund Juszczak, Louise Linsell, Virginia Chiocchia, Melanie Greenland, Anna Placzek, John Townend, Neil Marlow, Jane Sandall, Andrew Shennan, Umber Agarwal, Irshad Ahmed, Bini Ajay, Zarko Alfirevic, Rita Arya, Gabrielle BambridgeSummaryBackgroundIn women with late preterm pre-eclampsia, the optimal time to initiate delivery is unclear because limitation of maternal disease progression needs to be balanced against infant complications. The aim of this trial was to determine whether planned earlier initiation of delivery reduces maternal adverse outcomes without substantial worsening of neonatal or infant outcomes, compared with expectant management (usual care) in women with late preterm pre-eclampsia.MethodsIn this parallel-group, non-masked, multicentre, randomised controlled trial done in 46 maternity units across England and Wales, we compared planned delivery versus expectant management (usual care) with individual randomisation in women with late preterm pre-eclampsia from 34 to less than 37 weeks' gestation and a singleton or dichorionic diamniotic twin pregnancy. The co-primary maternal outcome was a composite of maternal morbidity or recorded systolic blood pressure of at least 160 mm Hg with a superiority hypothesis. The co-primary perinatal outcome was a composite of perinatal deaths or neonatal unit adm...
Source: The Lancet - Category: General Medicine Source Type: research