A woman with severe pre-eclampsia remote from term (28 weeks) is being managed expectantly at a tertiary centre. Which of the following neonatal benefits is the primary justification for attempting expectant management versus immediate delivery at this gestational age?
- A Reduction in maternal HELLP syndrome risk by 40%
- B Significant reduction in neonatal morbidity and mortality from extreme prematurity ✓
- C Avoidance of maternal corticosteroid exposure
- D Prevention of maternal stroke by maintaining placental perfusion
Explanation
The primary benefit of expectant management of pre-eclampsia remote from term is to gain gestational age and thereby reduce neonatal morbidity and mortality attributable to extreme prematurity — including respiratory distress syndrome, necrotising enterocolitis, intraventricular haemorrhage, and sepsis. Maternal risks of expectant management (HELLP, eclampsia, abruption) must be weighed against these neonatal benefits. Corticosteroids are administered during expectant management, not avoided; maternal HELLP risk is not reduced by expectant management; and stroke risk may actually increase with continued expectant management.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.