Biochemical parameter and feto-maternal outcome in preeclampsia: a hospital based observational study

Abstract

INTRODUCTIONPregnancy is a physiological phenomenon for most women. However, some develop problems during its evolution, putting both the mothers and the conceptus health at sake. Hypertensive disorders of pregnancy (HDPs) are one of the maternal diseases that cause detrimental effects on to the maternal, fetal, and neonatal health. The hypertensive disorders of pregnancy (HDPs) complicate about 3-10% of pregnancies. 1 They are one of the major contributors to maternal and fetal mortality and morbidity globally; maternal complications include eclampsia, stroke, and damage to the hepatic and renal organs etc. 2 Hypertension diseases during pregnancy includes pregnancy-induced hypertension (PIH) (without proteinúria), pre-eclampsia (with proteinuria), and eclampsia (pre-eclampsia with convulsions). Pregnancy termination reverses the clinical manifestations of the disease, suggesting that trophoblastic invasion has a central role in the pathogenesis of preeclampsia. 3 A recent study revealed that excessive placental secretion of soluble fms-like tyrosine kinase-1 may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. 3 In a multicenter study, approximately 30% of HDP cases were due to chronic hypertension, while 70% were due to gestational hypertension/preeclampsia. 4 ABSTRACT Background: Preeclampsia is one of the maternal diseases that cause detrimental effects on to the maternal, fetal, and neonatal health. The objective of the present study was to analyse maternal, perinatal outcome and investigation parameter in preeclampsia. Methods: This is an observational study and total of 90 consecutive patients were enrolled who has blood pressure ≥ 140/90 mmHg after 20 weeks of gestation with proteinuria (1+ by dipstick). Results: Among enrolled patients, 52 (58%) were in age group of 25-35 year and 51 (57%) were primigravida. Mean systolic and diastolic blood pressure of patients was 148±3.8 mm of Hg and 95±1.4 mm of Hg respectively. Most common presenting symptom was labor pain in 65 (72%) patients followed by edema in 61 (68%) patients. Most common complication was CNS symptom including seizure (Eclampsia) in 13 (15%) patients followed by vaginal bleeding (including abruption) in 12 (13%) patients. Mean hemoglobin level was 9.12±0.9 gm/dl. Mean urea and creatinine values were 34±4.6 mg/dl and 1.5±1.1 mg/dl respectively. Out of total 90 patients, 18 (20%) had elevated liver enzymes. Most common neonatal outcome was low birth weight 63 (70%) and 40 (44%) were preterm. APGAR score was less than 7 in 11 (12%) patients and more than 7 in 79 (88%) patients. Five (5.5%) newborn were still born. Conclusions: Preeclampsia is associated with multiple maternal and neonatal complications. Hence, there is a need for regular antenatal checkup to detect early and strengthening of neonatal intensive care units.