Chulalongkorn Medical Journal


Conservative management in chronic hypertensive women superimposed withpreeclampsia poses a threat of grave maternal complications, but may not improve perinatalsurvivals particularly in cases with preeclampsia in early gestations. This report presents acase of surviving baby after expectant management although the pregnancy complicatedwith superimposed preeclampsia at the onset of pre-viable gestational age. A 35-year-oldThai pregnant woman, underlying with pregestational diabetes mellitus class F and chronichypertension, was diagnosed as superimposed preeclampsia at 22 weeks of gestation. Sherefused elective termination and continued her pregnancy until 32 weeks of gestation. Cesareansection was performed and delivered a female baby with birth weight of 1,655 grams andApgar scores of 10 at both 1 and 5 minutes. The mother was discharged against advice onday 6 after delivery. Complications developed in the newborn included respiratory distresssyndrome, patent ductus arteriosus, pneumonia, sepsis, hyperbilirubinemia, necrotizingenterocolitis and bronchopulmonary dysplasia. However, the baby could be taken home atthe age of 68 days and her development was within normal limit at the age of 16 months.


Faculty of Medicine, Chulalongkorn University

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