OUTCOME OF HYPERTENSIVE DISORDERS IN PREGNANCY

BACKGROUND Hypertensive disorders in pregnancy are associated with severe maternal obstetric complications and are a leading contributor to maternal mortality. Hypertensive disorders in pregnancy seriously endanger the safety of the mother and foetus. Hypertensive disorders in pregnancy has been associated with adverse maternal and foetal outcome yet very few studies have this disease in India. This prospective study is to know the incidence of the disorders and associated risk factors and to assess the maternal and perinatal outcome in cases of hypertensive disorders in pregnancy. The purpose of this study is, 1. To study the incidence and to analyse the disease and risk factors associated with the disorders. 2. To assess the maternal and perinatal outcome of hypertensive disorders in pregnancy in our institute. MATERIALS AND METHODS A prospective study of women with hypertensive disorders in pregnancy was undertaken from February 2014 to January 2015 in the Department of Obstetrics and Gynaecology at Princess Esra Hospital. Analysis was carried out on 140 patients. Patients were further classified according to the National High Blood Pressure Education Working Group (NHBPEP) (2000) as having Gestational hypertension (83 cases), mild preeclampsia (38 cases), severe preeclampsia (13 cases), eclampsia (6 cases); 40 healthy pregnant non-hypertensive women were enrolled into the study as control. RESULTS The most common disorder was oedema, seen in 85.7% of cases. Proteinuria was also relatively common, 25.14% of patients with proteinuria of >= 300 mg/24 hours, 9.28% with proteinuria of >= 2 g/24 hours. Central nervous system involvement was observed in 7.1% of cases, elevated bilirubin levels in 1.4% of cases, visual symptoms in 2.8%, vaginal bleeding in 6.4% and HELLP (haemolysis, elevated liver enzymes and low platelet count) syndrome was reported in 0.7%. Stillbirths occurred in 3.5% of cases and overall perinatal mortality observed in 7.8% of cases. CONCLUSION Hypertensive disorder pregnant women were more prone to the adverse maternal and foetal outcome than in a non-hypertensive pregnant women, but in our study we have observed a decreasing trend when compared with that reported in other studies, which might be due to the increased number of hospital deliveries that has been occurred in our study, whereas complete prenatal care is associated with a better maternal and foetal outcome in HDP.