Immediate Perinatal Outcome of Neonates with Maternal Hypertensive Disorders in Pregnancy

Abstract

Introduction: Hypertensive disorders of pregnancy seem to be one of the major causes of maternal morbidity and mortality leading to 10-15% of maternal deaths especially in the developing world. This study examines the perinatal outcome of neonates with mothers having hypertensive disorder of pregnancy. Materials and Methods: Seventy three mothers and their newborn babies were selected. Mothers with Gestational hypertension, preeclampsia, eclampsia, chronic hypertension, preeclampsia superimposed on chronic hypertension were included. Gestational diabetics (GDM), chronic maternal diseases, infant of diabetic mother (IDM), babies with major congenital malformations were excluded. Results: Thirty five mothers (47.9%) had regular antenatal check up (ANC) and 38 (52%) had irregular. Nineteen mothers (26%) were primipara and 54 (74%) were multipara. Forty four mothers (60%) had positive family history or had own history of hypertensive disorder during their previous pregnancy. 13 mothers (17.8%) had normal vaginal delivery (NVD), 60 mothers (82.19%) had lower uterine cesarean section (LUCS). 30 babies (41%) were admitted. 44 mothers (60%) had gestational hypertension, 21 had (28.6%) pre-eclamtic toxemia (PET), 3 had (4.1%) eclampsia, 5 had (6.8%) essential hypertension 3 of them subsequently developed PET. Mean maternal age 26.86 years, gestational age 34.15 (±1.46)weeks among admitted and 36.30 (±1.6)weeks among non-admitted group. Mean birth weight was 1.69 (±0.39) kg. among admitted and 2.71 (±0.31) kg. in non-admitted babies. Seven pregnancies (9.58%) were twin, macerated 1 twin among was among 2 pregnancies (2.7%), 5 intra uterine death (IUD) observed in single pregnancy. Conclusion: Significant number of babies with maternal hypertensive disorder of pregnancy needed hospitalization, mean birth weight and gestational age was less than that of the non-admitted group.

Neonatal Outcomes from Mothers with Hypertension Disorders of Pregnancy: A Retrospective Study at a Referral Hospital in Rwanda

“…Many studies reported that hypertension during pregnancy increases the risk of maternal and perinatal, morbidity and mortality. [5][6][7] Comparable findings were observed in a study from Queen Elizabeth Central Hospital (QECH) neonatal ward records where 36.5% of neonates admitted in the ward from April to September 2012 had birth asphyxia.…”

“…[5] Hypertension in pregnancy is defined as either a systolic blood pressure (BP) of ≥140 mm Hg OR a diastolic ≥90 mm Hg. [6] Maternal hypertensive disorders are classified into four types: Chronic hypertension, that is known before pregnancy, or present in the first 20 weeks. New onset of hypertension that develops at or after 20 weeks gestation includes preeclampsia superimposed on chronic hypertension, preeclampsia, and eclampsia and gestational hypertension.…”

“…New onset of hypertension that develops at or after 20 weeks gestation includes preeclampsia superimposed on chronic hypertension, preeclampsia, and eclampsia and gestational hypertension. [6] Among these four hypertensive disorders, preeclampsia and eclampsia have the most significant effects on maternal and newborn morbidity and mortality. [6] However, timely and effective interventions using evidence-based practice could prevent morbidity and mortality.…”

“…[6] Among these four hypertensive disorders, preeclampsia and eclampsia have the most significant effects on maternal and newborn morbidity and mortality. [6] However, timely and effective interventions using evidence-based practice could prevent morbidity and mortality. [7] Numerous studies are addressing hypertensive disorders in pregnancy.…”

“…[7] Numerous studies are addressing hypertensive disorders in pregnancy. A systematic review and meta-analysis of 55 studies in the United States [6] reported pregnant women (n=795 221) with chronic hypertension had a higher incidence of superimposed preeclampsia (25.9%), a cesarean delivery (41.4%), preterm birth at 37 weeks or less (28.1%) of <2500 grams (16.9%) NICU care (20.5%) and perinatal death (4.0%). [8] In SSA, perinatal loss rates are higher than in highincome countries.…”