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.