I read with interest the article entitled “Expectant management of mild preeclampsia versus superimposed preeclampsia up to 37 weeks” in the April 2015 issue of the journal. This publication is of great clinical importance. This is the first multicenter cohort study of pregnancies complicated by preeclampsia or “mild preeclampsia” expectantly managed.

To fully understand the results, I would like to address 5 issues and some questions.

First, the study of Valent et al shows the latency period between diagnosis and delivery for mild preeclampsia of only 8 days and the principal indication to delivery was blood pressure; with that information, it is very difficult to accept home management of preeclampsia.

Second, if the time of prolongation in women with preeclampsia was 8 days, then you do not expectantly manage severe preeclampsia? If you do it, obviously it is <1 week.

Third, was second scheme of corticosteroid (percentage by group) used, and when was magnesium sulfate started?

Fourth, in the United States there is one study that showed the latency period in expectant management for severe preeclampsia of 15 days. Now in the United States there is a retrospective cohort study that shows a latency period in women with mild preeclampsia of only 8 days. That is a big surprise for physicians with clinical practice; what is the explanation?

Fifth, maternal adverse composite outcome occurred more frequently in women with superimposed preeclampsia (15%) compared to those with preeclampsia (5%). Small for gestational age and low birthweight were more frequent among neonates born to mothers with superimposed preeclampsia. With this findings and similar outcomes in women with chronic hypertension treated medically, is it justifiable to use antihypertensive drugs in patients with superimposed preeclampsia?