Clinical Characteristics, Management, and Perinatal Outcomes of Third-Trimester Preeclampsia at a Tertiary Hospital in Vietnam: A Retrospective Descriptive Study

Purpose: To describe the clinical and laboratory characteristics of third-trimester preeclampsia, summarize management patterns, and identify factors associated with adverse neonatal outcomes at a single public tertiary referral obstetrics and gynecology hospital in Vietnam. Patients and Methods: This retrospective descriptive study included 154 pregnant women diagnosed with preeclampsia and delivered at a single public tertiary referral obstetrics and gynecology hospital in Vietnam between August 1, 2022 and July 31, 2023. Clinical, laboratory, treatment, delivery, and neonatal data were analyzed using descriptive statistics and logistic regression. The composite adverse neonatal outcome was defined as the presence of one or more of the following: fetal growth restriction, preterm birth, intrauterine fetal death, low birth weight, neonatal respiratory morbidity, neonatal transfer, or perinatal death. Results: Severe preeclampsia accounted for 57.1% of cases. Maternal age ≥ 35 years was associated with severe disease (OR 3.00, 95% CI 1.56– 5.85), as were primigravidity (OR 1.98, 95% CI 1.03– 3.78), prior stillbirth (OR 2.94, 95% CI 1.10– 7.80), and assisted conception in the index pregnancy (OR 3.35, 95% CI 1.20– 9.36). Elevated liver enzymes, hypoalbuminemia, hyperuricemia, and elevated urea were more frequent in severe preeclampsia. All women with severe preeclampsia underwent cesarean delivery; the overall cesarean rate was 81.2%. Preterm birth occurred in 35.7% of pregnancies and fetal growth restriction in 10.4%. In multivariable analysis, adverse neonatal outcomes were associated with maternal age > 35 years (adjusted OR 2.24), gestational age < 34 weeks (adjusted OR 8.77), albumin < 35 g/L (adjusted OR 3.24), serum uric acid ≥ 400 umol/L (adjusted OR 3.93), severe hypertension (adjusted OR 2.29), and <=1 day of medical management before delivery (adjusted OR 9.34). Conclusion: Third-trimester preeclampsia at a public tertiary obstetrics and gynecology hospital in Vietnam was characterized by a high proportion of severe cases and a very high cesarean delivery rate. Older maternal age, primigravidity, assisted conception, severe hypertension, hyperuricemia, and hypoalbuminemia were associated with worse maternal or neonatal profiles. Earlier gestational age at birth remained the strongest predictor of adverse neonatal outcomes. Plain Language Summary: Preeclampsia is a serious condition in pregnancy that causes high blood pressure and can affect the mother’s organs and the baby’s health. It can lead to problems such as preterm birth, poor fetal growth, and in severe cases, life-threatening complications for both mother and baby. This study looked at 154 pregnant women with preeclampsia in the third trimester who were treated at a major public tertiary obstetrics and gynecology hospital in Vietnam. More than half of the women had severe preeclampsia. Cesarean section was very common, especially in severe cases. Many babies were born too early, and some had growth problems. The study also found that worse neonatal outcomes were more likely when the mother was older than 35 years, the baby was delivered before 34 weeks of pregnancy, the mother had severe high blood pressure, or blood tests showed low albumin or high uric acid levels. A very short time between hospital treatment and delivery was also linked with poorer neonatal outcomes. These findings show that preeclampsia remains a major challenge in maternal care. Early detection, close monitoring, timely referral, and careful delivery planning may help reduce risks for both mothers and babies, especially in referral hospitals and lower-resource settings.