Maternal and perinatal outcome of hypertensive disorders of pregnancy at a tertiary care hospital

ABSTRACT

To study the frequency of various hypertensive disorders of pregnancy and to determine their maternal and perinatal outcome. Retrospective descriptive study. Department of Obstetrics and Gynecology Unit III, Civil Hospital Karachi, from January 2002 to December 2007. A total of 626 cases were reviewed for age, parity, gestational age, diagnosis, antenatal and intra partum complications, mode of delivery and neonatal outcome. Data was analyzed using SPSS software [version 16]. Total number of deliveries during the study period was 11,718 and there were 626 cases of hypertensive disorders of pregnancy giving a frequency of 5.34%. Pre-eclampsia was seen in 308 [49%], severe pre-eclampsia in 85 [13%], eclampsia in 121 [19.2%], chronic hypertension in 41[6%] and postpartum eclampsia in 21 [3.3%] patients. There were 39 maternal deaths [case fatality rate 6.23%]. The mean ages for pre-eclampsia, severe pre-eclampsia, eclampsia and chronic hypertension were 28, 27, 24 and 29 [27 years] years respectively. The commonest maternal complication of hypertensive disorders was postpartum hemorrhage in 24 women [4.2%]. This was followed by placental abruption in 9 women [1.6%] and pulmonary edema in 8 women [1.4]. The prevalence of prematurity in pre-eclampsia, severe pre-eclampsia and eclampsia in study population was 14%, 5% and 8.6% respectively. Cesarean section was required for pre-eclampsia, severe pre-eclampsia and eclampsia in 46%, 51% and 61% of patients respectively. The main fetal complications were found to be still birth [14% in pre-eclampsia, 18% in severe pre-eclampsia and 15% in eclampsia] and low birth weight [31% in pre-eclampsia, 49% in severe pre-eclampsia and 52% in eclampsia]. Hypertensive disorders in pregnancy are an important cause of maternal and perinatal mortality and morbidity