Hypertensive disorders of pregnancy: frequency, maternal and fetal outcomes

ABSTRACT

To determine the frequency and distribution of different types of hypertensive disorders of pregnancy and to determine the impact of hypertensive disorders of pregnancy [HDP] on maternal and fetal outcomes. A descriptive retrospective study. The study was conducted in the department of Gynaecology and Obstetric of Isra University Hospital Hyderabad from January to December 2007. All the patients who were diagnosed to have hypertensive disorders of pregnancy during study period were categorized as group I. One hundred nineteen women delivered during the same period without hypertensive disorders of pregnancy were included as group II. The data regarding demographic and obstetrical parameters, associated risk factors, fetal and maternal complications were gathered from available data on medical record files. Total number of deliveries during the same period was obtained. Frequency of hypertensive disorders of pregnancy was calculated. Statistical analysis was performed by SPSS V11. Pearson's chi square and student's t test was used for comparison of variables in between two groups. P value < 0.05 was considered significant. The frequency of Hypertensive disorders of pregnancy was 8.9% in our study. The mean maternal age was 28.57 +/- 5.8 years and 26.56 +/- 5.0 years for group I and II respectively. Forty eight [76.2%] of group I patients were Unbooked for antenatal care, 37[58.7%] belonged to poor socioeconomic status and 82[45.1%] were multipara. Statistically significant difference was found for antenatal booking status [P. 0.04] and socioeconomic status [P. 0.01] and parity [P 0.04] in both groups. Twenty three [36.5%] patients from group I had past history of hypertensive disorders of pregnancy, while it was reported only by 8[6.7%] of group II patients. It was observed that women with HDP have strong family history of hypertension [P. <0.001]. Regarding maternal outcome more patients from group I were shifted to ICU as compared to group II. Maternal mortality was significantly high in group I [P <0.001]. The mean gestational age was 35.29 +/- 2.6 weeks and 38.03 +/- 1.3 weeks in group I and II respectively. The mean birth weight of baby was 2.5 +/- 0.73 kilograms and 2.8 +/- 0.41kilograms in group I and II respectively. Statistically significant difference was observed in both groups for mean gestational age [P<0.001] and mean birth weight of baby [P<0.001]. Statistically significant difference was observed for Preterm birth, Still born, Neonatal death and admission of newborn in neonatal intensive care unit [P <0.001], [P <0.001], [P <0.001], [P<0.001] respectively. The Perinatal mortality was 230/1000 births in group I, while it was 40/1000 in group II. Frequency of HDP is high in our set up. It is associated with high maternal and perinatal morbidity and mortality