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

Authors

  • Kritika Vats Department of Obstetrics and Gynaecology, Kasturba Hospital, Dariyaganj, New Delhi, India
  • Mohini Paul Department of Obstetrics and Gynaecology, Kasturba Hospital, Dariyaganj, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20163494

Keywords:

Hypertensive disorders of pregnancy, Fetal outcome at birth, IUD, Preterm delivery, Low birth weight, Low APGAR score, Admissions in NICU, Early neonatal deaths

Abstract

Background: Hypertensive Disorders of Pregnancy is a multifactorial disorder that seriously endangers the safety of the fetus during pregnancy. This study was conducted to study the perinatal outcome of this grave disorder in pregnancy and thus reducing the perinatal morbidity and mortality by prevention and proper management of this condition.

Methods: A “prospective case-control observational study” was conducted in the department of Obstetrics and Gynaecology, Kasturba Hospital, New Delhi.100 pregnant women presenting with hypertension from January 2014 to December 2014 were taken as cases and compared with 100 pregnant women (age and parity matched) in terms of perinatal outcome.

Results: As many as 6 cases with hypertensive disorder of pregnancy had intrauterine death of fetus as compared to 2 intrauterine death of fetus in controls. Birth weight >2.5kg was recorded in 68.4% of cases while 25.5% had weight between 1.5kg-2.5kg and 6.1% had weight <1.5kg as compared to controls which had 85% >2.5kg, 13% between 1.5kg-2.5kg and 2% had <1.5kg.The low birth weight in cases was due to IUGR and/or prematurity. 24.49% of babies of cases with hypertensive disorder of pregnancy had Apgar score <7 at 5 minutes after birth as compared to only 14% of control babies with Apgar <7. 25.53% of neonates born to cases were admitted in NICU whereas only 11% of neonates born to controls were admitted in NICU (p=.014). 4.3% of neonates born to cases ended up in early neonatal death while there was no early neonatal death among controls.

Conclusions: Thus low birth weight due to prematurity/IUGR and fetal hypoxia were the main reasons for fetal morbidity in hypertensive disorders of pregnancy.

References

Shah A, Fawole B, M'Imunya JM, Amokrane F, Nafiou I, Wolomby JJ, et al. Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa. International Journal of Gynecology and Obstetrics. 2009;107(3):191-7.

McClure EM, Saleem S, Pasha O, Goldenberg RL. Stillbirth in developing countries: a review of causes, risk factors and prevention strategies. Journal of Maternal-Fetal and Neonatal Medicine. 2009;22(3):183-90.

Prakash J, Pandey LK, Singh AK, Kar B. Hypertension in pregnancy: hospital based study. J Assoc Physicians India. 2006;54:273-8.

Hutter D, Kingdom J, Jaeggi E. Causes and Mechanisms of Intrauterine Hypoxia and Its Impact on the Fetal Cardiovascular System: A Review. International Journal of Pediatrics. 2010;2010:1-9.

Backes CH, Markham K, Moorehead P, Cordero L, Nankervis CA, Giannone PJ. Maternal Preeclampsia and Neonatal Outcomes. Journal of Pregnancy. 2011;2011:1-7.

Hofmeyr GJ, Belfort M. Proteinuria as a predictor of complications of pre-eclampsia. BMC Medicine. 2009;7:11.

Bhide A, Arulkumaran S, Damania KR, Daftary SN. Arias’ practical guide to high-risk pregnancy and delivery a south Asian perspective. 4th edition. Haryana: Reed Elsevier India Private Limited; Chapter 13, Hypertensive disorders in pregnancy; 2015:185-232.

Hassan M, Choudhury F, Begum M, Rahman H, Akhter S. Immediate Perinatal Outcome of Neonates with Maternal Hypertensive Disorders in Pregnancy. J Nepal Paediatr Soc. 2013;33(3):190-5.

Cunningham FG, Levano KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23rd edition. New York: Mc Graw Hill publishing division; Chapter 34, Pregnancy Hypertension; 2010:706-56.

Pawar DS. Perinatal outcome in cases of pih (MS thesis). Ahemdabad: Gujarat University. 2012.

Yadav S, Saxena U, Yadav R, Gupta S. Hypertensive disorders of pregnancy and maternal and foetal outcome: a case controlled study. J Indian Med Assoc. 1997;95(10):548-51.

Bangal VB. Purushottam A. Giri PA, Mahajan AS. Maternal and foetal outcome in pregnancy induced hypertension: a study from rural tertiary care teaching hospital in India. International Journal of Biomedical Research. 2011;2(12):595‐9.

Sachan R, Patel ML, Sachan P, Gaurav A, Singh M, Bansal B. Outcomes in hypertensive disorders of pregnancy in the north Indian population. Int J Womens Health. 2013;5:101-8.

Gawde A, Bhosale UT. A study of maternal and perinatal outcome in preeclampsia. International Journal of Recent Trends in Science and Technology. 2014;10(2):267-70.

Doddamani GB, Doddamani UG. Perinatal outcome in pre-eclampsia: A prospective study. Sch. J. App. Med. Sci. 2014;2(1C):291-3.

Wolde Z, Segni H, Woldie M. Hypertensive disorders of pregnancy in Jimma University specialized hospital. Ethiop J Health Sci. 2011;21(3):147-54.

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Published

2016-12-14

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Original Research Articles