Role of Placental Localisation in Prediction of Pregnancy Induced Hypertension

Abstract

BACKGROUNDPregnancy-induced hypertension is one of the leading causes of foetal and maternal morbidity and mortality worldwide. In our country, the prevalence of the disease is 5-15% and perinatal death rate due to PIH is 20%. Early detection becomes very essential as the disease is detected in advanced stages most of the times. Hence, screening for the prediction of PIH becomes necessary for improving maternal and foetal outcome. Aims-To evaluate the relationship between placental location and occurrence of PIH. To determine whether placental location can be used as a screening test for detection of PIH and to study maternal and foetal outcome in these patients. MATERIALS AND METHODSPrimigravidae with singleton pregnancy, without any medical disorder were considered for the study and were subjected to ultrasound examination to scan for gestational age, placental localisation-Central or lateral, amount of liquor amnii, congenital anomalies. The location of placenta was determined around or more than 24 weeks of gestation with real time ultrasound and repeat ultrasound was done in some patients at a later gestation to confirm the placental location. All patients with unilateral placenta on scan were followed up to delivery and the early detection of PIH reported, also the maternal and neonatal outcome was studied at delivery. Measurements were obtained & reported. The relationship between laterality of placenta and occurrence of PIH noted and discussed. Statistical Analysis Used-Statistical analysis was done using percentages and Chi-square test. Settings and Design-This was a prospective study conducted over a period of 6 months from September 2015 to February 2016 in the Department of Obstetrics and Gynaecology, SMBT Institute of Medical Sciences, Dhamangaon, Nasik. RESULTSThe present study showed the incidence of PIH in primigravidae to be 15.24% and incidence of lateral placentation in primigravidae being 15.8%. Our study also shows that 63 out of 83 primigravidae with lateral placenta developed PIH and 17 out of 425 primigravidae without lateral placenta developed PIH. The sensitivity and specificity of our study being 75.9% and 96.15% respectively. CONCLUSIONEvidence of lateral placenta on ultrasonography is a very useful addition to our armamentarium of antepartum testing for prediction of PIH and its management. Placental localisation has a definite potential to serve as a simple, non-invasive screening test for prediction of PIH. KEYWORDSPlacenta, Pregnancy-induced Hypertension. HOW TO CITE THIS ARTICLE: Naik SN, Naik AS, Phadol VA. Role of placental localisation in prediction of pregnancy induced hypertension. J. Evolution Med. Dent. Sci. 2017;6(20):1600-1602, DOI: 10.14260/Jemds/2017/351 BACKGROUND Pregnancy-induced hypertension (PIH) still remains one of the leading causes of foetal and maternal morbidity and mortality. In our country, the prevalence of the disease is 5-15% 1 and perinatal death rate due to PIH is 20%. Early detection becomes very essential as the disease is detected in advan...

An Observational Study of Maternal and Perinatal Outcome in Preeclampsia Cases in a Tertiary Care Center

“…In women with preeclampsia, 33 (70.21%) were primigravidae, and in normotensive women, 47 (56.63%) were primigravidae. The study by Nanthini et al [ 15 ] and Naik et al [ 10 ] was comparable to our study. In the Kaku et al [ 12 ] study, preeclampsia appeared 30-34 weeks earlier than ours.…”

“…In women with preeclampsia, among 47 women, 32 (68.09%) were diagnosed with preeclampsia between 36-39 weeks of pregnancy. In the study by Nanthini et al [ 15 ], 64.3% were diagnosed with preeclampsia between 36 and 40 weeks, and in Naik et al [ 10 ], 52.3% of the cases developed preeclampsia between 37 and 40 weeks, which was comparable to our study, but Kaku et al [ 12 ] found that preeclampsia was seen in 30-34 weeks, which was found to be earlier than the findings of our study. In this study, among 47 women with preeclampsia, only 44 or 95.7% of women without preeclampsia and only 4.26% with severe preeclampsia, which was comparable to Nanthini et al [ 15 ] and Naik et al [ 10 ] (15.26%) higher incidence of women with severe preeclampsia than our study.…”

“…The study by Bhalerao et al [ 16 ] had a higher (73.21%) vaginal delivery rate than our study, 28/43 (59.57%), and the study by Naik et al [ 10 ] (68.2%) was comparable to our study. In our study, 38.30% of cesarean sections were performed in preeclampsia, and the most common indication of cesarean sections with preeclampsia was abnormal Doppler (12.77%) and fetal distress (19.15%).…”