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In the face of preeclampsia, a central clinical decision is when to plan delivery. To assess delivery strategy, U.K. investigators randomized 900 women with preeclampsia without severe features (median gestational age at diagnosis, 35.6 weeks) to immediate delivery or expectant management. Delivery was initiated for women in the expectant-management group if they developed severe preeclampsia or if fetal compromise was diagnosed.
Median gestational age at birth was 36.0 weeks (immediate delivery) and 36.7 weeks (expectant management), and cesarean delivery rates were 55% and 61%, respectively. Adverse maternal outcomes (including severe hypertension) occurred less often in the immediate-delivery group than the expectant-management group (65%…