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A prospective study to compare maternal and perinatal outcome in hypertensive disorders in pregnancy in himalayan region of india

Authors:Jain Avni, Lal Manju, Archana Sharma, Namita Bajpai
Int J Biol Med Res. 2014; 5(2): 4071-4074  |  PDF File

Abstract

Abstract Worldwide 10-15% of the half million deaths that occur every year, are associated with hypertensive disorders of pregnancy. Preeclampsia and eclampsia is a major cause of maternal mortality (2-3% in India) and morbidities ranging from acute renal and liver failure to intracranial hemorrhages and DVT. Fetal complication includes prematurity, IUGR, stillbirths and neonatal deaths. The exact cause of preeclampsia, eclampsia is not known. The present study was conducted in sub Himalayan region of India, to determine the prevalence of hypertensive disorders in pregnancy and to study the maternal and perinatal outcome in these women. Out of a total of three thousands one hundred and twenty women who attended the antenatal clinic or presented in emergency during this period, a total of 70 antenatal cases with hypertensive disorders of pregnancy were included in the study. They were followed during labor and in postpartum period for six weeks. Our hospital is a tertiary care centre in the state of Uttarakhand and is surrounded by villages far and wide. Significantly more number of women (p=0.016) in the rural areas lacked antenatal care. It was noted that the severity of disease was more in those women, who did not get antenatal care (p=0.000.6) which is statistically significant. Among the 42(60%) live born babies, only 15 (35.71%) required admission to NICU. Respiratory distress syndrome (RDS) was the commonest cause of neonatal deaths occurring in 2 out of 5 (40%) neonatal deaths. The present study suggests that prognosis of preeclampsia depends on the severity, gestational age at the onset of disease. The unbooked pregnant women are highlighted in this study as being the most vulnerable to the development of eclampsia. Therefore antenatal booking and appropriate management of preeclampsia at the earliest, is critical to reduce the risk of this disease.