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Aim: To propose optimal management of intrauterine growth restriction(IUGR) cases associated with severe preeclampsia at 28-34 weeks ofgestation. Methods: Two hundred pregnant women with severepreeclampsia associated with growth restricted fetuses were followedwith doppler velocimetry of umbilical artery between 28-34 weeks ofpregnancy. Patients were grouped according to indications fortermination of pregnancy, first group consisted of severely affecteddoppler velocity waveforms (n:100) and the second group consisted ofthose whose cardiotocography and biophysic profile were unfavorable(n:100). Groups were compared according to perinatal outcomes (cesareanrates, gestational age at delivery, birth weight, Apgar scores anddemand for intubation and perinatal deaths). Results: The diagnosisto delivery interval is significantly higher in the second group(p<0.05), whereas there was no significant difference between groupsregarding gestational age at delivery and parity (p>0.05). Apgarscores were lower in the first group (p<0.05), and there wasincreased demand for intubation. Perinatal deaths were also lower inthe second group (p<0.05). Cesarean rate was significantly lowercompared with first group (p<0.05). Conclusion: Assessment ofdoppler velocimetry alone may not be enough at decision for terminationof pregnancy, biophysic profile and cardiotocography should be added toconfirm exact time for delivery of a premature fetus and to improveperinatal outcomes.

HOW TO MANAGE INTRAUTERINE GROWTH RESTRICTION ASSOCIATED WITH SEVERE PREECLAMPSIA AT 28-34 WEEKS OF GESTATION?