Urinary protein excretion and expectant management of early onset, severe pre-eclampsia

Objective: To evaluate the importance of proteinuria in the expectant management of early onset, severe pre-eclampsia. Methods: In this prospective series of 340 women, 24-h urine collections were performed and monitored twice weekly in a high-care ward. Results: Seventy-four women with at least two 24-h urine collections were grouped into women with a proteinuria increase of greater than or equal to 2 g (n = 29) and with women whose proteinuria decreased, or increased by < 2 g (n = 45). Major maternal complications, prolongation of gestation, and perinatal outcomes were comparable. Fifty-six (75%) women experienced an increase in proteinuria. When patients with heavy proteinuria (n = 83) were compared to those with moderate proteinuria (n = 257), maternal and perinatal outcomes were comparable. More days were gained before delivery in the heavy proteinuria group than in the moderate (12 vs. 9; P < 0.001). Conclusion: Most patients experienced increased proteinuria. Neither the rate of increase nor the amount of proteinuria affected maternal and perinatal outcomes. (C) 2002 International Federation of Gynecology and Obstetrics. Published by Elsevier Science Ireland Ltd. All rights reserved.