Management
At admission, all women underwent a physical and biochemical examination
according to standard recommendations. Maternal BP was monitored
continuously and laboratory tests were assessed at least once daily.
Magnesium sulfate for seizure prophylaxis and corticosteroid therapy for
fetal lung maturity were administered to all women. Antihypertensive
treatment was administered when BP was persistently 160/110 mmHg or
higher. Fetal assessment was performed by cardiotocograhy every day and
Doppler at least twice a week.
Indications for delivery were uncontrollable BP, maternal complications
(defined above), placental abruption or non-reassuring cardiotocographic
reading (29). Beyond 26 weeks, indications for delivery also included
persistent (>6 hours apart) ductus venosus (DV) Doppler
with reversed diastolic flow; and beyond 30 weeks persistent
(>6 hours apart) umbilical artery (UA) Doppler with
reversed end-diastolic flow or DV pulsatility index above the
95th centile for gestational age (30). Elective
delivery was performed beyond 34 weeks after completion of pulmonary
maturation. Clinicians and researchers were unaware of the angiogenic
factor levels as they were measured after delivery on stored samples.