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In modern obstetric practice, one of the most significant and urgent tasks is to ensure the safety of mother and child when a pregnant woman has severe forms of preeclampsia. Preeclampsia is a condition characterized by increased blood pressure and protein in the urine after 20 weeks of pregnancy, which can progress to a severe form, threatening the health and life of both mother and fetus. A feature of severe preeclampsia is the rapid development and progression of symptoms, which requires immediate and adequate medical interventions. The problem of severe preeclampsia has not lost its relevance for many years, since the frequency of this pregnancy complication remains quite high throughout the world, and the outcomes for mother and child can be extremely unfavorable. In this regard, the issues of choosing the optimal management tactics for pregnant women with severe preeclampsia, including the decision on the method of delivery, remain the subject of numerous studies. The monograph presents a review of modern literature on this issue and the results of the author's own research.