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Patients with pre-eclampsia are at great risk for maternal and neonatal morbidity and mortality. Every effort should be made to maximize the care for both. The risk to the fetus relates largely to the gestational age at delivery. The risk to the mother can be significant and includes the possible development of disseminated intravascular coagulation, intracranial hemorrhage, renal failure, retinal detachment, pulmonary edema, liver rupture, abruptio placentae, and death. Therefore, the risks and benefits of immediate delivery versus expectant management must be weighed carefully. Chapters such as this can, and should, only be regarded as a guideline. The providers involved in each individual patient's care should rely on their clinical judgment to determine which strategy is best for any particular patient. The ultimate goal should always be safety of the mother first, and delivery of a mature infant who will not require intensive and prolonged neonatal care.

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