Kavitha Reddy Kothapally1
To analyse the maternal outcome in pregnancy induced hypertension and improve the management strategies.
Pregnancy induced hypertension is a medical disease peculiar to pregnancy, making pregnancy a high risk condition. Among medical disorders complicating pregnancy, it stands next to anaemia in prevalence. It is responsible for majority of the maternal morbidity and mortality. It also has an adverse perinatal outcome. Hence, early detection and timely intervention of women with pregnancy induced hypertension is important for good maternal and perinatal outcome.
MATERIAL & METHODS
The present Prospective Observational study was done from April 2015 to February 2016 in the department of obstetrics & gynaecology at Bhaskar medical college and general hospital, Yenkepally, Moinabad, Telangana. A total of 102 pregnant women with pregnancy induced hypertension were enrolled into the study. Demographic details like age, parity, previous obstetric history of pregnancy induced hypertension and diabetes, past history of polycystic ovarian disease, treatment for infertility, gestational age at which hypertension developed in the present pregnancy were noted. Relevant investigations were performed. Gestational age of delivery, mode of delivery and maternal complications were noted.
The incidence of pregnancy induced hypertension was 4% in the study population. About 59.8% developed pregnancy induced hypertension in the third trimester. Out of this, 64.7% cases were gestational hypertension and 35.3% cases were preeclampsia. Nearly half (41.7%) of preeclampsia cases were severe preeclampsia. Postpartum haemorrhage is the commonest complication (13.7%), next being imminent eclampsia (7.8%), abruption (4.9%), eclampsia (3.9%) and HELLP syndrome (0.98%). 80% of cases could be delivered beyond 37 weeks of gestational age. 71.57% of cases had lower segment caesarean section for indicated conditions. More than half of pregnancy induced hypertension could be managed conservatively with bed rest and observation. Remaining cases required antihypertensives for severe preeclampsia.
Pregnancy induced hypertension is the common medical disease in pregnancy in the rural pregnant women in India especially among primigravidae in the third trimester. Preeclampsia is associated with maternal complications like postpartum haemorrhage, imminent eclampsia and eclampsia, abruptio placenta. Abruptio and eclampsia are associated with adverse perinatal outcome. Regular antenatal checkups helps in early detection and management of pregnancy induced hypertension. Timely intervention can prevent maternal mortality and reduce morbidity.