Preeclampsia and fetal well-being.

Thirty-three women with preeclamptic toxemia were retrospectively divided into three groups, according to clinical data, urinary estriol excretion, fetal growth, fetal movements and fetal heart recordings. In group 1 (six patients) there was no fetal growth retardation, and fetal motor function and heart rate were normal. In group 2 (17 patients) there was fetal growth retardation, estriol values were usually low, and fetal movements and heart rate were normal. In group 3 (10 patients) fetal movements decreased markedly almost until complete cessation for 12 to 24 h, and pathological changes were present in fetal heart recordings. A classification of preeclamptic toxemia according to these criteria is suggested. Patients who manifest placental metabolic failure, such as the women in group 2, should be hospitalized for observation only, as no immediate danger to the fetus is apparent. If there are signs of severe fetal distress and cardiomotor failure, such as in group 3, prompt delivery is essential to prevent fetal death in utero.