Preterm Preeclampsia and Timing of Delivery: A Systematic Literature Review

Abstract Introduction Preeclampsia, a multifactorial disease with pathophysiology not yet fully understood, is a major cause of maternal and perinatal morbidity and mortality, especially when preterm. The diagnosis is performed when there is an association between arterial hypertension and proteinuria or evidence of severity. There are unanswered questions in the literature considering the timing of delivery once preterm preeclampsia has been diagnosed, given the risk of developingmaternal complications versus the risk of adverse perinatal outcomes associated with prematurity. The objective of this systematic review is to determine the best timing of delivery for women diagnosed with preeclampsia before 37 weeks of gestation. Methods Systematic literature review, performed in the PubMed database, using the terms preeclampsia, parturition and timing of delivery to look for studies conducted between 2014 and 2017. Studies that compared the maternal and perinatal outcomes of women who underwent immediate delivery or delayed delivery, in the absence of evidence of severe preeclampsia, were selected. Results A total of 629 studies were initially retrieved. After reading the titles, 78 were selected, and their abstracts, evaluated; 16 were then evaluated in full and, in the end, 6 studies (2 randomized clinical trials and 4 observational studies) met the inclusion criteria. The results were presented according to gestational age range (