Frequency Of Pregnancy-induced Hypertension Research Articles

To Study Serum β-HCG in Early Second Trimester as Predictors of Pregnancy Induced Hypertension

Background: Hypertensive disorders of pregnancy are a mysterious and clinically complex category of pregnancy problems that account for a significant burden of disease in both industrialized and less industrialized nations. The aim of this study is to estimate Serum β-HCG levels in early second trimester as predictors of pregnancy-induced hypertension. Methodology: A cross-sectional study was conducted among pregnant females in their second trimester attending the OPD clinic in the Department of Obstetrics & Gynaecology, JK Hospital, LNMC & RC, Bhopal, from January 2019 to June 2020. A total of 150 pregnant women were included in the study based on inclusion and exclusion criteria. Data was collected and entered into an Excel sheet and analyzed using EpiInfo software with appropriate statistical methods. Result: The study observed that the majority of pregnant women (52%) were in the 26-30 years age group. The highest number of women were at 17-18 weeks of gestation, and most of them were primigravida (39.3%). The mean β-HCG level of mothers in the pregnancy induced hypertension (PIH) group was 54297.8±22302.7, while that of mothers in the normal group was 27018.2±11255.7. The difference between the means was statistically very highly significant (P<0.001). The sensitivity and specificity of elevated β-HCG levels as a predictor of PIH were 67.2% and 75%, respectively, with a positive predictive value of 62.9% and a negative predictive value of 78.4%. Conclusion: Pregnancy-induced hypertension remains a little understood entity, despite the enormous impact of its complications on maternal and fetal outcomes. The study concludes that the frequency of pregnancy-induced hypertension at a tertiary care hospital is 38.6%. Elevated serum β-HCG levels in women with second trimester pregnancy indicate an increased risk of gestational hypertension and preeclampsia, and higher β-HCG levels are associated with the severity of the disease. Women with raised β-HCG levels should be arefully followed up for hypertension, and appropriate referrals to a tertiary care center for better treatment should be made.

Prevalence of Pregnancy-Induced Hypertension and Pregnancy Outcomes

Background: The most frequent medical comorbidity during pregnancy is hypertension, rendering an elevated menace of unfavorable outcomes for equally mother and infant. It is a substantial public health concern, characterized by eclampsia, chronic hypertension, and preeclampsia. Objectives: The study determined occurrence of pregnancy-induced hypertension (PIH) and pregnancy outcomes, in the locality of Pakistan. Methods: The cross-sectional research appraised 05 districts of Pakistan in 2021-22. The study comprised 1920 patients affected with PIH. The demographic characteristics, laboratory and clinical values and pregnancy outcomes were recorded on the approved questionnaire. Results: Prevalence of PIH in pregnant females in study area was recorded as 13.70%. A significant proportion of PIH-affected females had genetic predisposition (51.14%), followed by abortion history (15.52%), history of hormonal imbalance (9.94%), history of Cesarean section (7.50%) and history of stillbirth (0.88%). Pregnancy outcome revealed that 16 (0.833%) women died of the PIH, 31 suffered from renal failure, 36 from pulmonary edema, 4.06% were affected with abruptio placentae and 103 suffered from HELLP syndrome. Similarly, the neonatal complications revealed that 27 fetuses died to mothers’ PIH, 111 suffered from asphyxia (5.78%) at the time of birth and 13 infants were abnormal and had different congenital anomalies. Practical implication: It emphasized the need for improved prenatal care, early detection of pregnancy-induced hypertension, and meticulous management of the condition in order to improve maternal and neonatal outcomes, especially in high prevalence regions such as Pakistan. Conclusion: The frequency of PIH in Pakistan was high (13.70%) and women had a greater risk of adverse pregnancy outcomes. With good prenatal care and continuous monitoring of the mother and fetus, perinatal outcomes including maternal morbidity and infant mortality can be avoided. Keywords: Asphyxia; Hypertension; Neonatal mortality; Perinatal outcomes.

The correlation between AGT gene polymorphism and neonatal hypoxic-ischemic encephalopathy (HIE).

To explore the correlation between the rs2067853 polymorphism in angiotensinogen (AGT) gene and neonatal hypoxic-ischemic encephalopathy (HIE). A total of 96 neonatal patients with HIE and 123 healthy neonates were selected. General clinical data were collected and TaqMan-MGB probe method was adopted to detect the rs2067853 polymorphism in angiotensinogen (AGT) gene. The frequency of advanced maternal age, low maternal age, maternal renal insufficiency, abnormal labor, amniotic fluid contamination and umbilical cord abnormality in the observation group was higher than that in the control group (p<0.05), and there was no significant difference between the two groups in the frequency of pregnancy-induced hypertension or eclampsia, maternal anemia, routine prenatal examination, natural childbirth, placental abnormality and abnormal birth weight (p>0.05). There was a difference in genotype distribution frequency between the two groups (p<0.05), while there was no difference in the allele distribution frequency between the two groups (p>0.05). The recessive model had differences between the two groups (p<0.05), while the dominant and additive model had no differences between the two groups (p>0.05). HIE is correlated with maternal factors, fetal growth, uterine environment and labor process, and the rs2067853 polymorphism in AGT gene is associated with HIE.

The relationship between body adiposity index and pregnancy-induced hypertension in third-trimester pregnant women.

The aim of this study was to evaluate the relationship between body adiposity index (BAI) and pregnancy-induced hypertension (PIH) in third-trimester pregnant women. This study included 126 women in the third trimester of pregnancy. All participants completed anthropometric measurements and ultrasonic testing. The formula of BAI was hip circumference (cm)/height (m)-18. The frequency of PIH were significantly higher in the upper tertile group (31.0%) than in the low tertile group (7.1%) and the middle tertile group (4.8%) (P<0.01). The area under curve values for the accuracy of BAI in identifying PIH were 0.784. The optimal threshold of BAI for identifying PIH was 36.0. The sensitivity was 72.2% and the specificity was 85.1%. BAI was correlated with PIH. The performance of BAI for identifying third-trimester pregnant women with PIH was moderately accurate.

Increased fetal heart rate variability in periventricular leukomalacia

ObjectiveThis study used quantitative analysis to determine whether increased variability in fetal heart rate (FHR) is related to the risk of developing periventricular leukomalacia (PVL). MethodsWe analyzed 124 FHR traces of neonates delivered preterm at 27–33weeks’ gestation to 105 mothers. FHR traces 1–3h before delivery were translated into power-spectrum curves using a fast Fourier transformation. The total power (the area under the curve of 1–10 cycles per minute), segmental power of every cycle per minute, peak power, and frequency edges were calculated, and their relationship with the subsequent development of PVL was examined. ResultsTotal power was significantly higher in the PVL group (n=9, median 1813, range 1064–2426) compared to the non-PVL group (n=114, median 1383, range 381–3324, p=0.029). Infants in the PVL group had greater segmental power in segments with 1–2, 2–3, and 9–10 cycles per minute, than those in the non-PVL group. Total power of ⩾1550 was significantly correlated with the subsequent development of PVL and premature rupture of membranes. Furthermore, the frequency of pregnancy-induced hypertension was significantly reduced in the fetuses with a total power of ⩾1550. ConclusionOur study suggests that a fetus with increased FHR variability is at risk of developing PVL. This study provides additional evidence supporting the contribution of antenatal factors to the subsequent development of PVL.

The relationship between neck circumference and pregnancy-induced hypertension in the third trimester pregnant women

Objective: The purpose of this study was to evaluate the relationship between neck circumference (NC) and pregnancy-induced hypertension (PIH) in the third trimester pregnant women. Methods: The study included 126 women who were in the third trimester pregnancy. All subjects completed a standard sleep questionnaire, anthropometric measurements and ultrasonic testing. Results: Pregnant women with NC ≥34.7 cm had significantly higher frequency of PIH than pregnant women with NC <34.7 cm (35.6% versus 2.5%, χ2 = 25.863, p = 0.000). Conclusions: The increase of NC was independent risk factor for PIH in the third trimester pregnant women.

T10.2 PREDO trial-acetylsalicylic acid in preventing pre-eclampsia in high-risk women

Screening of 1226 nulliparous women by means of doppler uteroplacental flow-velocity waveforms in early pregnancy identified 148 (12%) as being at high risk of pregnancy-induced hypertension. After exclusions and refusals, 100 women were randomly allocated to groups receiving either low-dose aspirin (75 mg daily; 48 patients) or identical placebo (52 patients) for the remainder of the pregnancy. The difference between the aspirin and placebo groups in the frequency of pregnancy-induced hypertension (13% vs 25%) did not achieve significance, but there were significant differences in the frequencies of proteinuric hypertension (2% vs 19%) and hypertension occurring before 37 weeks' gestation (0% vs 17%). Fewer aspirin-treated than placebo-treated women had low birthweight babies (15% vs 25%), but this difference was not significant. The only perinatal death in the aspirin group followed a cord accident during labour, whereas the 3 perinatal deaths in the placebo group were all due to severe hypertensive disease. No maternal or neonatal side-effects were observed in either group.

When children "have children"--reproduction biological problems in girls between 11 and 15 years of age

The aim of the present study was to evaluate the obstetric risk in pregnant adolescents under 16 years of age. From July 1, 1970 to June 30, 1993, 188 girls aged 11-15 years were delivered at the 2nd Department of Obstetrics and Gynaecology, Vienna; 4569 primiparous women between 20 and 24 years with singleton pregnancies served as a control group. No significant differences between the two groups were found for the frequency of pregnancy-induced hypertension (2.1% vs. 3.5%), premature delivery rates (24.4% vs. 29.8%), percentage of babies weighing less than 2500 g (10.1% vs. 9.1%), mean birthweight (3082 g vs. 3117 g), frequency of intrauterine growth retardation (2.1% vs. 2.4%) and malformations (1.6% vs. 3.1%) and perinatal mortality to the end of the first week (1.1% vs. 0.5%). Adolescent mothers were found to have more spontaneous deliveries (85.1% vs. 74.9% in the control group, p < 0.005), lower Caesarean section rates (6.4% vs. 11.3%, p < 0.05) and fewer babies with a birthweight exceeding 4000 g (1.1% vs. 4.3%, p < 0.05). For the first time, the pregnancy outcome of European adolescents was studied over a period of 23 years. We conclude on the basis of our results that maternal and neonatal risk in mothers under 16 years of age does not exceed the obstetric risk in adult mothers.

Calcium supplementation prevents pregnancy-induced hypertension by increasing the production of vascular nitric oxide

Pregnancy-induced hypertension (PIH) remains a common cause of maternal and fetal morbidity and mortality. During the past 7 years, some progress has been made in the prevention of PIH. Specifically, clinical studies have shown that supplementation with calcium can significantly reduce the frequency of PIH, specially in populations with a low calcium intake. We have suggested that, in such a population, calcium supplementation is a safe and effective measure for reducing the frequency of PIH. Thus, the purpose of this article is to advance a hypothesis about the mechanism by which calcium supplementation reduces the risk of PIH. We propose that dietary calcium supplementation reduces the frequency of PIH by maintaining the serum ionized calcium level which is crucial for the production of endothelial nitric oxide, the increased generation of which maintains the vasodilatation that is characteristic of normal pregnancy.

Low-dose aspirin in prevention and treatment of intrauterine growth retardation and pregnancy-induced hypertension

Meta-analysis of data from several controlled trials has shown that low-dose aspirin reduces the risk of pregnancy-induced hypertension (PIH) and intrauterine growth retardation (IUGR) in women at high risk of these disorders. We have assessed the efficacy of low-dose aspirin in women judged to be at moderate risk.Women were included on prophylactic criteria— age under 18 or over 40 years, mild or moderate chronic hypertension (diastolic pressure between 90 and 110 mm Hg), nephropathy with normal renal function and blood pressure, history of PIH or IUGR, and twin pregnancy—or therapeutic criteria—PIH or early signs of IUGR in current pregnancy. Eligible women were randomly assigned treatment with 50 mg aspirin daily until delivery (583) or no treatment (523); 18 and 46 women, respectively, were lost to follow-up. The groups were well matched for baseline characteristics. We found no differences between the no-treatment and aspirin groups in numbers of spontaneous (5 vs 2) or therapeutic (1 vs2) abortions, stillbirths (14 vs 13), perinatal mortality (35·7 vs 28·6 per 1000 births), mean birthweight (2858 [SD 729] vs 2874 [795] g), proportion of infants with birthweights below the 10th centile (95 [18·3%] vs 117 [19·0%]), or births before 37 weeks' gestation (184 [35·6%] vs 209 [33·9%]). Nor did the groups differ in the frequency of PIH with or without proteinuria (51 [15·2%] vs 81 [19·3%]). There was no difference in mean birthweight between the treatment groups in separate analyses according to criteria for trial entry and week of gestation at randomisation.Our study gives little support to the notion that low-dose aspirin is beneficial in women at moderate risk of PIH or IUGR.

Doppler Ultrasound and Aspirin in Recognition and Prevention of Pregnancy-Induced Hypertension

Screening of 1226 nulliparous women by means of doppler uteroplacental flow-velocity waveforms in early pregnancy identified 148 (12%) as being at high risk of pregnancy-induced hypertension. After exclusions and refusals, 100 women were randomly allocated to groups receiving either low-dose aspirin (75 mg daily; 48 patients) or identical placebo (52 patients) for the remainder of the pregnancy. The difference between the aspirin and placebo groups in the frequency of pregnancy-induced hypertension (13% vs 25%) did not achieve significance, but there were significant differences in the frequencies of proteinuric hypertension (2% vs 19%) and hypertension occurring before 37 weeks' gestation (0% vs 17%). Fewer aspirin-treated than placebo-treated women had low birthweight babies (15% vs 25%), but this difference was not significant. The only perinatal death in the aspirin group followed a cord accident during labour, whereas the 3 perinatal deaths in the placebo group were all due to severe hypertensive disease. No maternal or neonatal side-effects were observed in either group.

Doppler ultrasound and aspirin in recognition and prevention of pregnancy-induced hypertension

Screening of 1226 nulliparous women by means of doppler uteroplacental flow-velocity waveforms in early pregnancy identified 148 (12%) as being at high risk of pregnancy-induced hypertension. After exclusions and refusals, 100 women were randomly allocated to groups receiving either low-dose aspirin (75 mg daily; 48 patients) or identical placebo (52 patients) for the remainder of the pregnancy. The difference between the aspirin and placebo groups in the frequency of pregnancy-induced hypertension (13% vs 25%) did not achieve significance, but there were significant differences in the frequencies of proteinuric hypertension (2% vs 19%) and hypertension occurring before 37 weeks' gestation (0% vs 17%). Fewer aspirin-treated than placebo-treated women had low birthweight babies (15% vs 25%), but this difference was not significant. The only perinatal death in the aspirin group followed a cord accident during labour, whereas the 3 perinatal deaths in the placebo group were all due to severe hypertensive disease. No maternal or neonatal side-effects were observed in either group.