ABSTRACT
Background: Hypertensive disorders during pregnancy are the most common medical complication seen during pregnancy, affecting around 5-10% of all pregnancies. Raised blood pressure in pregnancy is the major cause of fetomaternal morbidity and mortality. The most important feature in preeclampsia is hypertension which is supposed to be due to vasospastic phenomenon in kidney, uterus, placenta and brain. Altered lipid synthesis leading to decrease in PGI2:TXA2 ratio is also supposed to be an important way of pathogenesis in pregnancy induced hypertension.Methods: This one-year prospective case control study total 200 pregnant women attending antenatal care and admitted in eclampsia ward fulfiling the inclusion criteria were studied. Serum lipid profile was estimated by semiautomatic analyzers. Statistical analysis of data was done by student’s t-test and p-value.Results: Mean total cholesterol in pregnancy induced hypertension was 278.5±52.52 mg/dl and normal pregnancy was 245.47±20.075 mg/dl. Mean triglycerides in pregnancy induced hypertension was 249.88±92.575 mg/dl and normal pregnancy was 206.89±46.345 mg/dl. Mean HDL in pregnancy induced hypertension was 43.69±4.135 mg/dl and normal pregnancy was 49.9±6.501 mg/dl. Mean LDL in pregnancy induced hypertension was 174.43±39.083 mg/ dl and normal pregnancy was 151.22±19.92 mg/dl. Mean VLDL in pregnancy induced hypertension was 46.885±15.143 mg/dl and in normal pregnancy was 40.964±9.061 mg/dl, total cholesterol, low density lipoprotein, very low density lipoprotein, triglycerides were increased in pregnancy induced hypertension when compared to normal pregnancy, which is statistically significant.Conclusions: We concluded that the Patient who developed pre-eclampsia have abnormal lipid profile. This abnormal lipid profile is responsible for endothelial dysfunction. This endothelial dysfunction may play a key role the pathophysiology of pre-eclampsia. Early detection of these parameters may help patient by preventing complications and is going to aid in better management of pre-eclampsia.
ABSTRACT
Background: Hypertensive disorder of pregnancy complicates 5 to 8% of pregnancies and is a major cause of maternal and perinatal morbidity and mortality. Hypertensive disorders of pregnancy account for nearly 18% of all maternal deaths worldwide, with an estimated 62000-77000 deaths per year.Methods: This one-year prospective case control study total 200 pregnant women attending antenatal care and admitted in Eclampsia ward fulfilling the inclusion criteria were studied. Fetal and maternal outcomes data recorded and documented. Statistical analysis of data was done by student’s t-test and p-value.Results: In PIH 68% women had normal vaginal delivery (p=0.004) 10% women had instrumental delivery. In PIH group 22% women had emergency caesarian section and in normotensive group 10% women had emergency caesarian section. In PIH group 58% delivered at term and 42% had preterm delivery. In normotensive 95% delivered at term and 5% had preterm delivery (p <0.001). PIH group 29% women developed IUGR whereas in normotensive group all women had normal growth velocity (p <0.001). In PIH group 69% mothers had newborn with birth weight <2.5 kg and 31% women had newborn with birth weight >2.5 kg (p=0.0009). While In normotensive group only 9% women had newborn with birth weight <2.5 kg. In PIH group, 24% newborn babies needed NICU admission and in normotensive group only 5% newborn needed NICU admission (p=0.001). In PIH group 76% women had normal maternal outcome (p <0.001). 11% had associated abruption (p=0.0019). In the rest 13% patient develop PRES.Conclusions: We concluded that there is a significant rise of complication in mothers having PIH and also there is an increased risk of delivering low birth weight and preterm babies. The early use of antihypertensive drugs, optimum timing of delivery and strict fluid balance, anticonvulsants in cases of eclampsia will help to achieve successful outcome.
ABSTRACT
Background: Hypertensive disorders during pregnancy are one of the most common medical complication seen during pregnancy, affecting around 5-10% of all pregnancies. Spectrum of this disease ranges from mildly elevated blood pressure with minimal clinical significance to severe hypertension with multi organ dysfunction. Pre-eclampsia complicates about 2-8% of all pregnancies. Pre-eclampsia incidence in India is about 8-10%. Various studies have depicted that, there is a strict relationship between PIH and elevated serum β-hCG level.Methods: This one-year prospective case control study toteled 200 pregnant women attending antenatal care and admitted in eclampsia ward fulfiling the inclusion criteria were studied. Serum βhCG levels were estimated by chemiluminescent microparticle immunoassay. Statistical analysis of data was done by student’s t-test and p-value.Results: The mean β hCG level in PIH patients was found to 36851.59 mIU/ml with standard deviation of 22916.58 while the mean β hCG in normotensive patient was 15433.26 mIU/ml with standard deviation of 6861.56. (p <0.001). The mean β hCG level in gestational hypertensive patients was 25206.19 mIU/ml with a standard deviation of 8696.9. The mean β hCG level in pre-eclamptic patients was 61697.67 mIU/ml with standard deviation of 18498.57. The mean β hCG level were 84106.38 mIU/ml with standard deviation of 11295.05 in the eclamptic patient. The above values were statistically significant (p <0.001).Conclusions: We concluded that there was a striking relation between the PIH including pre-eclampsia and eclampsia with the elevated serum βhCG level. Concluding that early detection of altered serum βhCG shell aid in better management of pre-eclampsia and eclampsia cases which would play a pivotal role in improving the maternal and fetal outcome.