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Expectant Management of Severe Preeclampsia Remote From Term In A Rural Setting of Niger Delta, Nigeria: Is It Time to Define a Protocol?

Abstract

Mbachu Ikechukwu Innocent, Eleje George and Osuagwu Ihechimere Kelechi

Background: Severe preeclampsia is one of the leading causes of maternal and perinatal mortality worldwide. Management of cases remote from term poses a great challenge to the caregiver and the patient. This is more pronounced in developing countries with limited resources and high premium on children. This article highlighted the challenges in the management and we presented a successfully expectant management of a case in a rural setting.

Case presentation: We presented Mrs JV, a 33 year old booked G7P1 with no living child who presented at the gestational age of 24 weeks plus 3 days with severe hypertension and proteinuria. Expectant management was instituted and pregnancy was ended via an emergency caesarean section at 29 weeks of gestation with delivery of extreme low birth baby. Both mother and baby are in good health.

Conclusion: Management of severe preeclampsia remote from term should be individualized and can be feasible in a rural setting in developing countries. Availability of tertiary health institutions in rural settings will help in the management of these patients.

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