{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T11:55:13Z","timestamp":1793361313037,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T00:00:00Z","timestamp":1485475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre\u2010eclampsia before 26 weeks of gestation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Nationwide case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>All Dutch tertiary perinatal care centres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All women diagnosed with severe pre\u2010eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women were identified through computerised hospital databases. Data were collected from medical records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Maternal complications [<jats:styled-content style=\"fixed-case\">HELLP<\/jats:styled-content> (haemolysis, elevated liver enzyme levels, and low platelet levels) syndrome, eclampsia, pulmonary oedema, cerebrovascular incidents, hepatic capsular rupture, placenta abruption, renal failure, and maternal death], neonatal survival and complications (intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis, bronchopulmonary dysplasia, and sepsis), and outcome of subsequent pregnancies (recurrent pre\u2010eclampsia, premature delivery, and neonatal survival).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 133 women, delivering 140 children. Maternal complications occurred frequently (54%). Deterioration of <jats:styled-content style=\"fixed-case\">HELLP<\/jats:styled-content> syndrome during expectant care occurred in 48%, after 4 days. Median prolongation was 5 days (range: 0\u201325 days). Neonatal survival was poor (19%), and was worse (6.6%) if the mother was admitted before 24 weeks of gestation. Complications occurred frequently among survivors (84%). After active support, neonatal survival was comparable with the survival of spontaneous premature neonates (54%). Pre\u2010eclampsia recurred in 31%, at a mean gestational age of 32 weeks and 6 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Considering the limits of prolongation, women need to be counselled carefully, weighing the high risk for maternal complications versus limited neonatal survival and\/or extreme prematurity and its sequelae. The positive prospects regarding maternal and neonatal outcome in future pregnancies can supplement counselling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Severe early onset pre\u2010eclampsia comes with high maternal complication rates and poor neonatal survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14512","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T13:08:02Z","timestamp":1485522482000},"page":"1440-1447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Maternal and neonatal outcomes in women with severe early onset pre\u2010eclampsia before 26 weeks of gestation, a case series"],"prefix":"10.1111","volume":"124","author":[{"given":"MF","family":"van Oostwaard","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology IJsselland Ziekenhuis Capelle aan den Ijssel the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"van Eerden","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Maasstad Ziekenhuis Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MW","family":"de Laat","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Academisch Medisch Centrum Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJ","family":"Duvekot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Erasmus Medisch Centrum Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJHM","family":"Erwich","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Universitair Medisch Centrum Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KWM","family":"Bloemenkamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leids Universitair Medisch Centrum Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AC","family":"Bolte","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Radboud Universitair Medisch Centrum Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JPF","family":"Bosma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Isala Ziekenhuis Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SV","family":"Koenen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Universitair Medisch Centrum Utrecht Utrecht the 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