English

Abstract

BACKGROUND: Hypertensive disorder of pregnancy is a major challenge for obstetricians contributing to adverse maternal and perinatal outcome. AIM: To assess the maternal demographic characteristics and maternal and perinatal outcome of the different hypertensive disorders of pregnancy including preeclampsia, gestational hypertension and chronic hypertension in a tertiary care hospital so that we can evolve strategies to avoid adverse outcome in our population. SETTINGS AND DESIGN: Government Medical College, Kozhikode, Kerala. Descriptive study. MATERIALS AND METHODS: We studied 100 cases each of preeclampsia, gestational hypertension and chronic hypertension who were admitted at the Government Medical College, Kozhikode during the study period from January 1, 2013 to April 15 2014. Cases were analyzed for the demographic factors, obstetric outcome and maternal and perinatal outcome. Statistical analysis: Data was expressed in percentages. RESULTS: Majority of the cases in our study population belonged to the age group of 20 to 34 years. Primipara were more in preeclampsia and gestational hypertension whereas in chronic hypertension 72% were multipara. Only 34% of preeclampsia patients were term gestation. Labor was induced in 60% of Group1, 57% of Group2 and 38% of Group3 patients. 44% of Group 1, 37% of Group 2 and 49% of Group 3 underwent caesarean section.10% of preeclampsia, 4% of gestational hypertension and 6% of chronic hypertension resulted in still birth. Of the live born babies 43.3% of preeclampsia mothers had asphyxiated babies. In Group 1, only 20% babies had birth weight above 2.5 Kg. 42.2% of Group 1 babies were admitted in neonatal ICU in contrast to only 9.4% of Group 2 and 9.6% of Group 3. In Group1, 14.4% of live born babies died in neonatal period compared to only 1% of Group1 and 3.2% of Group 3. Maternal complications were found more in Group1 with one case of maternal death in Group 3. CONCLUSIONS: Women with hypertensive disorders have a high risk of adverse maternal and fetal outcome. It is essential to have quality antenatal care services with good obstetric and neonatal care at delivery for early recognition and management of hypertensive disorders of pregnancy. Preeclampsia either alone or superimposed on chronic hypertension presents the major risk. Formulating guidelines of management of hypertensive disorders will help bring down the associated morbidity and mortality.