FREQUENCY AND IMPACT OF HYPERTENSIVE DISORDERS OF PREGNANCY
AbstractBackground: Hypertensive disorders are one of a major cause of maternal mortality and morbidity especially in developing countries. This cross sectional descriptive study was carried out to determine frequency of hypertensive disorders of pregnancy and its impact on maternal and perinatal outcome. Methods: Records of 150 pregnant hypertensive ladies presenting at gynaecology Unit-1 of Civil Hospital Karachi from January to December 2010 was reviewed for demographic profile, mode of delivery, maternal and perinatal outcome. Statistical analysis was performed by SPSS-15. Results: Total deliveries during study period were 2702. Out of 2702 deliveries 150 (5.5%) mothers were hypertensive. Out of 150 hypertensive cases 30% were cases of gestational hypertension, 58% were cases of toxaemia of pregnancy and 12% were cases of chronic hypertension. Maternal age, gravida, parity was lowest in toxaemia of pregnancy group. Commonest maternal complication was eclampsia (32%). There were 6 (4%) maternal deaths. Caesarean section was mode of delivery in 54% cases. Conclusion: Hypertensive disorders of pregnancy are an important cause of maternal and perinatal mortality and morbidity.Keywords: Preeclampsia, eclampsia, maternal mortality, perinatal mortality rate.
Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000;183:1–22.
Vigil-De Gracia P, Montufar-Rueda C, Ruiz J. Expectant management of severe preeclampsia and preeclampsia superimposed on chronic hypertension between 24–34 weeks gestation. Eur J Obstet Gynecol Reprod Biol 2003;107:24–7.
Yucesoy G, Ozkan S, BodurH, Tan T, Cahskan E, Vural B, et al. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: A seven year experience of a tertiary care centre. Arch Gynecol Obstet 2005;273:43–9.
Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol 2003;102:181–92.
Zhang WH, Alexender S, Bouvier-Colle MH, Macfarlane A, MOMS-BGroup. Incidence of severe preeclampsia, post partum haemorrhage and sepsis MOMS-B survey. BJOG 2005;112(1):89–96.
Aali BS, Ghafoorian J, Mohamed-Alizadeh S. Severe preeclampsia and eclampsia in Kerman, Iran: complications and outcomes. Med Sci Monit 2004;10(4):163–7.
Matter F, Sibai BM. Eclampsia V111. Risk factors for maternal morbidity. Am J Obstet Gynecol 2000;182:307–12.
Altman D, Carroli G, Duley L, Farrell B, Moodley J, Neilson J. Do women with preeclampsia and their babies , benefit from magnesium sulphate? The Magpie trial a randomized placebo-controlled trial. Lancet 2002; 359:1877–90.
Knight M: Eclampsia in the United Kingdom 2005. Br J Obstet Gynecol 2007;114:1072–8.
Iams JD, Romero R, Culhane JF, Goldenberg RL. Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. Lancet 2008;371:164–75.
Hossain N, Shah N, Khan N, Lata S, Khan NH. Maternal and Perinatal outcome of Hypertensive Disorders of Pregnancy at a Tertiary care Hospital. J Dow Uni Health Sc 2011;5(1):12–6.
CLASP; a randomized trial of lowdose aspirin for the prevention and treatment of pre eclampsia among 9364 pregnant women. CLASP (Collaborative Low dose Aspirin in Pregnancy. Collaborative Group. Lancet 1994; 343:619–29.
Imdad A, Jabeen A, Bhutta ZA. Role of calcium supplementation during pregnancy in reducing risk of developing gestational hypertensive disorders: a meta-analysis of studies from developing countries. Bio Med Central 2011;11(3):1471–2458.
Teran E, Hernandez I, Nieto B, Tavara R, Ocampo JE, Calle A. Coenzyme Q10 supplementation during pregnancy reduces the risk of pre eclampsia. Int J Gynecol Obstet 2009;105:43–5.
Samadi AR, Mayberry RM, Zaidi AA, Pleasant JC, McGhee N Jr, Rice RJ. Maternal hypertension and associated pregnancy complications among African-American and other women in the United States. Obstet Gynecol 1996; 87: 557–63.
Khan KS, Wodyla D, Say L, Gulmezole AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006;367:1066–74.
Nisar N, Memon A, Sohoo NA, Ahmed M. Hypertensive disorders of pregnancy: frequency, maternal and fetal outcomes. Pak Armed Forces Med J 2010:60:113
Nadkarni J, Bahl J, Parekh P. perinatal outcome in pregnancy associated hypertension. Indian Paediatr 2001;38:174–8.
Ananth CV, Basso O. Impact of pregnancy induced hypertension on still birth and neonatal mortality. Epidemiology 2010;21(1):118–23.
Jafarey SN. Maternal mortality in Pakistan-compilation of available data. J Pak Med Assoc 2002;52:539–44.
Duley L. The global Impact of Pre eclampsia and eclampsia. Semin Perinatol 2009;33:130–7.
Ronsmans C, Campbell O. Quantifying the fall in mortality associated with interventions related to hypertensive diseases of pregnancy. BMC 2011;11:1471–2458.
Maternal mortality: helping women off the road to death, WHO Chron 1986;40(5):175–83.