Maternal and Foetal Outcome in Pregnancy Induced Hypertension: A Study From Rural Tertiary Care Teaching Hospital in India

Abstract

Background: Preeclampsia and eclampsia have been recognized as clinical entities since the times of Hippocrates. Pregnancy induced hypertension (PIH) is one of the commonest disorders associated with the increased risk of maternal and fetal complications. It is reported in the world literature that the incidence of eclampsia is on the decline, but still a menace in developing countries. Objectives: To study the maternal and foetal outcome in pregnancy induced hypertension. Material and Methods: A prospective randomized study was carried out from February 2009 to January 2010 in the Department of Obstetrics and Gynecology of Pravara Rural Hospital, Loni, India. A total of 100 pregnant women with PIH were enrolled in the study. A pre-tested interview tool was used to collect necessary information such as detailed history, clinical examination findings and investigations performed. Results were analysed using SPSS 13.0 Results: In the present study, the overall incidence of PIH was 8.96%, which includes preeclampsia in 7.26% and eclampsia in 1.70%. Preterm labour was the commonest maternal obstetrical complication observed in 18% of mild PIH and 48% of severe PIH cases. Prematurity was the commonest foetal complication seen in 17.99%, 47.62% and 52.63% of mild PIH, severe PIH and Eclampsia cases respectively. Conclusion: Pregnancy induced hypertension is a common medical disorder seen associated with pregnancy in the rural population, especially among young primigravidas, who remain unregistered during pregnancy. Maternal and fetal morbidity and mortality can be reduced by early recognition and institutional management.

Maternal and perinatal outcome associated with pregnancy induced hypertension

“…which is comparable but less than the incidence in the studies done by Chhabra S et al 5.2% and Sundaram S 5% and by Bangal V et al 7.26%. [3][4][5] In the present study, the incidence of eclampsia was 0.9% which is more or less the same showing a marginally decreasing trend compared to studies done over the past 10 years. This may be attributed to increased awareness, early diagnosis and prompt treatment of pre eclampsia.…”

“…In this present study number of vaginal deliveries 117 (50%) were equal to the number of caesarean deliveries 117 (50%) which is similar to the study done by Uddin AW et al 7 In which the rate of cesarean section is about 50.8% where as in the studies done by Bangal V et al and by Parmar MT et al is 35% and 37% respectively (Table 7). 5,6 This comparatively higher rate of caesarean section in our study is attributed to the fact that our institution is a tertiary referral centre situated in the rural area and most of the patients were referred after development of complications. HELLP syndrome is characterized by hemolysis, elevated liver enzymes and low platelet counts.…”

“…Eclampsia was responsible for maximum number of preterm deliveries 58.3% followed by severe preeclampsia 50%, which is comparable with the studies by Gandhi M et al, Bangal V et al and by George JN et al where in, the incidence was 29%, 37%, and 31% respectively (Table 9). 5,9,10 This indicates that severity of the disease is directly related to the prematurity of the baby. 32 out of 182 cases in this study had Apgar <6 (17.5%) at 1 min and 22 out 182 cases in this study had Apgar <8 (11.9%) at 5 minutes.…”

Effects of Different Grades of Pih on Pregnancy Outcome

“…Fox noted that in many hypertensive gestations there is decreased foeto-placental weight ratio because of a compensatory hypertrophy of placenta under the influence of cases of mild, severe PIH and eclampsia respectively. Kapoor et al concluded that, the incidence of premature babies was 23% in PIH and prematurity was one of the major risk factors for increasing the perinatal mortality [29]. [30].…”

Thrombocytopenia in hypertensive disorders of pregnancy

“…33 Bangal et al excluded gestational HTN and clubbed mild and severe PIH. 34 While Mohammed et al have studied the variations of platelet indices in PIH in a fixed study group of 20 cases each under each category, whereby the incidence of each cannot be commented upon and Parmar et al have categorized PIH cases into mild, moderate and severe PIH. 35,36 Wolde et al's method to categorize cases with PIH based on the National High BP Education Working Group (2000) criteria has been done in this study owing to feasibility and simplicity of categorization into the five mentioned groups.…”