Abstract

HYPERTENSION & PREGNANCY: A COMPLEX COCKTAIL OF OUTCOMES

Pallavi K. N. and Anil Raj D.*

ABSTRACT

Background: Hypertensive disorders complicate 5 to 10 percent of all pregnancies and together they are one member of the deadly triad—along with haemorrhage and infection—that contributes greatly to maternal morbidity and mortality. Prevention of any disease process requires a meticulous knowledge of its etiology and pathogenesis. Prediction, prevention, timely diagnosis, early management and providing optimal health care helps to reduce majority of the adverse outcome. Aim: To study Maternal & Fetal outcome in Hypertensive disorders of pregnancy. Materials and Methods: This study was a prospective observational study of total 224 patients with Hypertensive disorders of Pregnancy attending the Little Flower Hospital Angamaly, Kerala in the time period of 2 years. Antenatal women at any gestational age satisfying inclusion and exclusion criteria were included in the study. Consent for the study taken after explaining the need for the study. Statistical analysis was done by SPSS software using Mean, Standard deviation, percentage of various parameters, chi-square test to calculate the P value. Observation and Results: 224 patients were included in the study. Primigravida were 58.92%. Age group of 20-29 (69.19%) with mean age of 26.76 ± 4.26 (Yrs). 72.77% of women had normal BMI, 21.43% had overweight, and 5.36% were obese. 56.2% of women were diagnosed with Gestational hypertension, 16.5% mild Preeclampsia, 19.1% Severe Preeclampsia, 2.7% Eclampsia and 5.4% Chronic hypertension. 59.3% of cases underwent caesarean section and 40.6% delivered vaginally. There was 32.6% total Preterm deliveries & with a statistically significant number in Severe Preeclampsia & Eclampsia (57.5%). Antenatal maternal & fetal complications include abruption placenta (3.57%), FGR (14.3%), IUD (1.34%), HELLP (1.7%), Preterm labour (4.9%), PPROM (6.2%), Oligohydramnios (8%), ARF (0.4%). Postnatal maternal complications include Eclampsia (1.3%), HELLP (0.4%), ARF (0.4%), DIC (1.33%), PPH (3.57%) with no maternal mortality. Neonatal complications include LBW (25.45%), NICU admission (23.7%), Still birth (1.8%), Birth Asphyxia (0.4%), Respiratory Distress (3.12%), Meconium Aspiration (3.12%), & Neonatal death (0.4%). Conclusion: To conclude, though hypertensive disorders in pregnancy is a non-preventable disease, when proper guidelines are followed during regular antenatal check-up, early diagnosis &tertiary referral in needed cases, we can definitely reduce the severity of the disease, & reduce maternal/fetal morbidity and mortality. Complications are unpredictable but early recognition of complications and timely intervention helps to reduce the severe maternal/neonatal morbidity and mortality.

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