Perinatal Outcome in Women with Hypertensive Disorders of Pregnancy in Rural Tertiary Center of Northern India: A Retrospective Cohort Study"

Background: Hypertensive disorder of pregnancy is associated with adverse maternal, perinatal outcome. Objective: To know the perinatal outcome in women with hypertensive disorders of pregnancy. Methods: Present retrospective cohort study was conducted in the Obstetrics and Gynecology department of the rural tertiary center of Northern India over one year (January-December 2018) on 205 antenatal women with hypertensive disorders of pregnancy at gestation >= 28 weeks. All the participants on the basis of diagnosis were divided into four groups: Group 1 Gestational hypertension; Group 2 Pre-eclampsia; Group 3 Eclampsia and Group 4 with Chronic Hypertension. Demographic features, gestational age, the onset of labor, mode of delivery and perinatal outcome including birthweight, Apgar scores, morbidity and mortality were recorded and compared between four groups. Statistical analysis was done using software SPSS 22.0. version. Results: Of 205 participants, 93 had Gestational Hypertension, 68 Pre-eclampsia; 36 Eclampsia, 06 Chronic Hypertension. The mean age of presentation was 24.96 +/- 3.535 years. Average gestation at birth for group 1 was 37.91 +/- 2.38 weeks, group 2: 36.50 +/- 3.312 weeks, group 3: 34.44 +/- 4.062 weeks and group 4: 37.97 +/- 1.524 weeks. The majority of participants had induced labor especially in pre-eclampsia and eclampsia groups with a spontaneous vaginal delivery as the most common mode. 1 and 5-minute Apgar scores, birth weight were lower in eclampsia and pre-eclampsia women. Severe disease was associated with the adverse perinatal outcome with maximum neonatal morbidity and mortality in eclampsia and pre-eclampsia group. Conclusion: Hence, hypertensive disorder of pregnancy was associated with adverse perinatal outcome, especially in women with severe disease (Eclampsia and Pre-eclampsia).