Outcomes in hypertensive disorders of pregnancy in the North Indian population

Abstract

Introduction:Hypertensive disorders complicating pregnancy seriously endanger the safety of the mother and fetus during pregnancy. Very few studies have explored hypertensive disorders of pregnancy in India, even though this disease has been associated with adverse maternal and perinatal outcomes. This study aimed to analyze the disease pattern and risk factors associated with the disorder and assess the maternal and fetal outcomes in cases of hypertensive disorders of pregnancy.Subjects and methods:This case-control study was carried out over 1 year from 2011 to 2012 at the Department of Obstetrics and Gynecology, King George’s Medical University, Lucknow, Uttar Pradesh, India. A total of 149 patients were enrolled in the study. As seven were lost to follow-up, analysis was carried out on 142 cases. Patients were further classified according to the National High Blood Pressure Education Program Working Group (2000) as having mild preeclampsia (65 cases), severe preeclampsia (32 cases), or eclampsia (45 cases). Thirty-one healthy pregnant non-hypertensive women were enrolled into the study as controls.Results:The most common manifestation was edema, seen in 90% of cases. Proteinuria was also relatively common, 26.76% of patients with proteinuria of ≥300 mg/24 hours, 47.88% with proteinuria of ≥2 g/24 hours, and 25.35% with a urinary protein excretion of 3–5 g/24 hours. Central nervous system involvement was observed in 42.2% of cases, elevated bilirubin levels in 47.0%, visual symptoms in 6.4%, vaginal bleeding in 11.3%, and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome was reported in 2.80%. Maternal deaths occurred in 2.8% of cases, all of which were from the eclampsia group. Stillbirths occurred in 16.9% of cases, and overall neonatal death observed in 4.23% of cases.Conclusion:Women with hypertensive disorders of pregnancy were more prone to adverse maternal and fetal outcomes than normotensive pregnant women, but we observed a decreasing trend in the present study compared with that reported in other studies, which might be due to the increased number of hospital deliveries that occurred in our study.

Maternal & Perinatal outcome in Hypertensive Disorders of Pregnancy in a Tertiary Care Hospital in Northern India

“…Ascites was observed in 2.8%, pleural effusion in 1.2%, HELLP syndrome in 0.8%, cortical venous thrombosis in 2.8% and duodenal perforation in one patient [16]. Prakash et al [10] reported HELLP syndrome in 7.5% of cases of pre eclampsia whereas Sachan et al [17] in 2013 reported it to be 3.07% [10][11][12][13][14][15][16][17]. All these additional features worsen the pregnancy outcome and are required to be watched for meticulously.…”

Study of fetal outcome in hypertensive disorders of pregnancy in a tertiary care maternity hospital of Delhi

“…Similarly in a study done by Sachan R et al, 43.70% of cases had weight >2.5kg, 50% had weight 1.5kg-2.5kg, 6.33% had weight <1.5kg. 13 Also Gawde A et al study had 75% cases with fetal birth weight ≥2.5kg and 25% cases had fetal birth weight <2.5kg. In patients with hypertensive disorder of pregnancy, the growth retardation of the fetus occurs due to decreased utero-placental blood flow and ischemia.…”

Evaluation of Laboratory Disorders in Admitted Neonates in NICU Who Were Born to Preeclamptic Mothers

“…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 (5). Preeclampsia can lead to acute maternal complications such as progression to eclampsia, acute renal or hepatic failure, pulmonary edema, cardiovascular disorders, intracranial hemorrhage, disseminated intravascular coagulation and HELLP syndrome (hemolysis-elevated liver enzymes and low platelet count) (1,2).…”