History Of Pregnancy-induced Hypertension Research Articles

Pregnancy-induced hypertension awareness, knowledge and its risk factors: A cross-sectional study.

Pregnancy-induced hypertension (PIH) has severe implications for maternal morbidity and mortality; thus, boosting pregnant women's awareness and knowledge of this medical condition is crucial for improving the mother's and foetus's health. This study assessed the awareness and knowledge of PIH and its risk factors among pregnant women in Mdantsane, South Africa. This cross-sectional study involved 249 conveniently selected and consenting pregnant women attending antenatal care clinics in Mdantsane, Buffalo City Metropolitan Municipality, South Africa. A self-designed questionnaire was utilised to collect data. Descriptive statistics, chi-square (χ2) test and multivariate logistic regression analysis were performed. The significance level was 0.05. Over 50% of the women were knowledgeable about PIH and associated risk factors ((χ2=4.92; p = 0.04). The prevalence of PIH was 51.8%, and married women were more aware of the PIH risk factors (71.1%). Women with previous pregnancies were more likely to be aware of PIH (OR = 17.1, 95%; CI = 9.09 to 32.15) compared to first time mothers. Women in age group 36-45 were 2.5 times more likely to be aware of PIH (OR = 2.5, 95% CI: 1.19-3.24) compared to women aged <35 years. Likewise, women aged 36-45 years were two times more likely to be knowledgeable about risk factors for PIH (OR = 2.3, 95% CI: 1.14-2.81) compared to women aged <35 years. Married women were more likely to be aware of PIH risk factors (OR = 2.70, 95% CI = 1.35-5.47) than unmarried women. Moreover, pregnancy increases the likelihood (OR=12.8, 95% CI: 6.97-23.58) of being aware of PIH risk factors. There was a significant difference between the mean ages of women who knew about PIH risk factors and those who do not (t=3.49, Mean difference = 3.49, p=0.0001, 95% CI (2.54; 4.44)). The prevalence of PIH was high. Age, history of PIH, previous pregnancy, and marital status were predictors of PIH knowledge/awareness and risk factors for PIH. Context-specific health education programmes during prenatal visits are crucial to improving pregnant women's knowledge of PIH.

Impact of Pregnancy Induced Hypertension on Babies

Background: Pregnancy-induced hypertension (PIH) is a relatively common pregnancy disorder that causes variable maternal and fetal problems. This may increase the number of perinatal asphyxia, sepsis, still birth etc. It also has a significant affect on birth weight which is also related to gestational age. Objectives: To observe the impact of pregnancy induced hypertension on their newborn babies and compare the findings with the babies of normotensive mother. Materias and Methods: This case control study was conducted from July 2016 to December 2016. The study group was selected from the babies of pregnancy induced hypertension (PIH) mothers and control group selected from babies of a normotensive mother attending in Obstetrics department of Dhaka Medical College Hospital, Dhaka having the inclusion and exclusion criteria. The total number of 100 neonates were included consecutively in this study. 50 neonates born to mothers with pregnancy-induced hypertension were grouped as cases and 50 neonates born to normotensive mothers were grouped as control. Results: The study revealed that, the highest frequency of neonatal morbidities were perinatal asphyxia (22%) among the babies of PIH mother. Stillbirth it was found 12 % . The duration of pregnancy were also affected by PIH where most of the babies were preterm (88%) and complete-term pregnancy found only (12%). It should be mentioned that those mother having history of preeclampsia delivered more premature babies (p &lt;0.001). Another important outcome birth weight related to gestational age was also very important which were measured as the highest for SGA 92% and AGA 8%. The weight of the baby were significantly (p&lt;0.001) reduced in those who had a history of PIH and the mean weight was 1592.78 ± 470.06. Conclusion: Prematurity, Small for gestational-age babies and perinatal asphyxia are more common in Pregnancy induced hypertension group than in the normotensive group.&#x0D; KYAMC Journal Vol. 13, No. 04, January 2023: 204-207

Immediate outcome of meconium aspiration syndrome with respect to neonatal maturity and birth weight

Background: About 13% of live births result in MSAF, and as gestational age at birth increases, this percentage increases as well. About 5% of babies born with MSAF develop MAS (meconium aspiration syndrome). The mortality rate from MAS is still as high as 3-5 percent, even with modern NICU care. Methods: This study was a hospital-based a prospective observational study over an 18-months period, and all babies were admitted to the NICU who satisfied the MAS criteria were added in the study. The babies were monitored for their immediate outcome. Results: MAS was more prevalent among mother who had a history of pregnancy-induced hypertension and in neonates who were in fetal distress. With a mean gestational age of 38-40 weeks and a mean birth weight of 2.76 kg, it is more common in term newborns and babies born by caesarean section. The most frequent cause of death, birth asphyxia, which accounted for 30.7% of cases of MAS, was most frequently associated with neonates who were depressed at birth. Conclusions: Term and post-term neonates with weight &gt;2.5 kg at birth are frequently associated with MAS. When meconium was present below the vocal cords, a low APGAR score at 1 minute and thick meconium were associated with a higher mortality rate. Non-vigorous babies require early and effective management, and early assisted ventilator support may be necessary when there is evidence of thick meconium. Asphyxiated babies should be carefully monitored. effective intrapartum suctioning, neonatal care, an accurate diagnosis and prompt treatment can significantly lessen the complications, morbidity and mortality in meconium aspiration syndrome.

Abstract 130: History Of Pregnancy Induced Hypertension Is Associated With Markers Of Cerebral Small Vessel Disease: The Northern Manhattan Study And Washington Heights-Hamilton Heights-Inwood Columbia Aging Project

Background: A history of pregnancy-induced hypertension (PIH) is associated with higher risk of developing cerebrovascular disease. Data are lacking on the relationship between PIH, chronic hypertension, and MRI markers of cerebral small vessel disease (CSVD) in older people. Methods: We recruited parous individuals without dementia from the Northern Manhattan Study and the Washington Heights-Inwood Washington Heights-Hamilton Heights-Inwood Columbia Aging Project, two long-running prospective cohort studies in New York City. Detailed obstetric and medical histories were obtained by interview. We defined history of PIH as self-report of at least one pregnancy complicated by gestational hypertension, preeclampsia or eclampsia. We categorized participants as having no hypertension, current hypertension without history of PIH, or current hypertension with history of PIH. Number and location of infarcts and white matter hyperintensity (WMH) volume was assessed by MRI. We used generalized linear models to compare imaging outcomes between groups, adjusting for demographics and cardiovascular risk factors. To account for the effects of early onset hypertension, we performed a sensitivity analysis in NOMAS participants only, adjusting for hypertension as a time varying covariate. Results: A total of 221 participants were interviewed (mean age 69 years [SD 7.5]; 22% white, 28% non-Hispanic Black, 48% Hispanic) of whom 128 (58%) had current hypertension without history of PIH, and 16 (7%) had current hypertension with history of PIH. Adjusting for covariates, hypertensive participants with a history of PIH had higher WMH volume, but no difference in deep silent brain infarcts (Table). Conclusions: In a multiethnic cohort of older parous individuals, those with hypertension and a history of PIH had the highest volume of WMH, suggesting a higher burden of CSVD.

PS-BPR01-7: CONCURRENT SOMATIC MUTATIONS IN CTNNB1 AND GNA11 IN AN ALDOSTERONE-PRODUCING ADENOMA

Background: Aldosterone-producing adenoma (APA) is a major subtype of primary aldosteronism (PA), a common form of secondary hypertension. In the past decade, there has been significant progress in the determination of genetic causes of APA. The use of next-generation sequencing (NGS) has led to the identification of somatic mutations in APA that cause excess aldosterone production. Most of the affected genes encode ion channels or transporters. Somatic activating mutations in CTNNB1 (β;-catenin) have also been detected in 2–5% of APA. As a possible pathogenesis, an association of CTNNB1-mutated APA with pregnancy and menopause has been proposed. A recent study reported double somatic mutations in CTNNB1 and GNA11/Q in APA. However, due to its rare incidence, characteristics of APA with these mutations are not well determined. Herein, we report a case of APA harboring somatic CTNNB1 and GNA11 mutations. Case presentation: A 46-year-old Japanese woman presented with hypertension and spontaneous hypokalemia. She had no history of pregnancy-induced hypertension. She had regular menstrual cycle at presentation. Endocrine testing showed elevated plasma aldosterone concentration (677.5 pg/mL) under suppressed renin (plasma renin activity, 0.3 ng/mL/h). Computed tomography revealed a 2 cm right adrenal mass. Adrenal venous sampling indicated excess aldosterone production from the right adrenal gland. NP-59 scintigraphy further demonstrated increased tracer uptake in the right adrenal lesion. She underwent right laparoscopic adrenalectomy. Histologic diagnosis of the resected tumor was adrenocortical adenoma based on the Weiss criteria. Notably, Ki-67 labeling index was high (6% at hotspots). After surgery, her blood pressure and serum potassium both normalized. Based on the PASO (the primary aldosteronism surgical outcome) study criteria, PA remained clinically and biochemically cured at follow-up 18 months after surgery. Methods: Formalin-fixed, paraffin-embedded adrenal tumor tissue was used for immunohistochemical and genetic analysis. Results: Immunohistochemistry (IHC) showed high and diffuse expression of CYP11B2 (aldosterone synthase) within the tumor, whereas 11β;-hydroxylase (CYP11B1, a steroidogenic enzyme for cortisol biosynthesis) was mostly negative. VSNL1, a marker for the zona glomerulosa where physiologic aldosterone biosynthesis occurs, was highly expressed within the tumor. CYP11B2 IHC-guided targeted NGS identified concurrent somatic CTNNB1 (p.D32Y) and GNA11 (p.Q209H) mutations with similar variant allele frequencies (29.5% and 29.7%, respectively). Conclusions: To best of our knowledge, this is the first Asian case of APA with CTNNB1 and GNA11 mutations. Detailed clinical and histologic examination would provide useful information for better characterization of patients with PA due to these rare mutations.

Assessment of Pregnant Women for Information About Hypertension in Pregnancy: A Cross Sectional Study from a Teaching Hospital Outdoor

Background: The term "pregnancy-induced hypertension," or PIH, refers to a pattern of elevated blood pressure that appears during a woman's pregnancy. It is one of the most important factors contributing to the maternal mortality rate and infant morbidity rate worldwide. In addition to its impacts, this risk can be decreased by the transmission of health education that emphasises early identification and appropriate treatment of disease. This study aims to determine the current levels of knowledge about PIH among pregnant women in the general population. Methods: This study was undertaken with the participation of 300 pregnant women, and data were gathered through direct interviews with the participants. The participants' verbal consent to participate in the research was acquired in the form of their acceptance to participate in the study through the use of a questionnaire prepared specifically for the research project. Both the Student T-test and the ANOVA test were utilised in order to explore the parameters associated with pregnancy awareness. Place of Study: Hayat memorial teaching hospital Duration of Study: August 2021 to June 2022 Results: The study shows that 80.6% of pregnant women were aware with the idea of PIH, according to the results of this survey. The first individuals they consulted in order to get knowledge were their friends and family members, followed by medical specialists. As a result of their performance, 47.1% of the participants obtained a score that indicated they had a low level of comprehension. The participants' ages, the type of family they came from, whether or not they had a history of PIH or gestational diabetes, whether or not they participated in sports, and whether or not they attended frequent antenatal care appointments were all important factors in calculating their knowledge score. Conclusions: The outcomes of the study suggested that pregnant participants had a poor understanding of PIH; this underscores the importance of increasing public knowledge and education about the illness. Keywords: Pregnancy induced hypertension (PIH), Preeclampsia

Medications for preventing hypertensive disorders in high-risk pregnant women: a systematic review and network meta-analysis

ObjectivesTo determine the relative effectiveness of medications for preventing hypertensive disorders in high-risk pregnant women and to provide a ranking of medications using network meta-analysis.MethodsAll randomized controlled trials comparing the most commonly used medications to prevent hypertensive disorders in high-risk pregnant women that are nulliparity and pregnant women having family history of preeclampsia, history of pregnancy-induced hypertension in previous pregnancy, obstetric risks, or underlying medical diseases. We received the search results from the Cochrane Pregnancy and Childbirth’s Specialised Register of Controlled Trials, searched on 31st July 2020. At least two review authors independently selected the included studies and extracted the data and the methodological quality. The comparative risk ratios (RR) and 95% confidence intervals (CI) were analyzed using pairwise and network meta-analyses, and treatment rankings were estimated by the surface under the cumulative ranking curve for preventing preeclampsia (PE), gestational hypertension (GHT), and superimposed preeclampsia (SPE). Safety of the medications is also important for decision-making along with effectiveness which will be reported in a separate review.ResultsThis network meta-analysis included 83 randomized studies, involving 93,864 women across global regions. Three medications, either alone or in combination, probably prevented PE in high-risk pregnant women when compared with a placebo or no treatment from network analysis: antiplatelet agents with calcium (RR 0.19, 95% CI 0.04 to 0.86; 1 study; low-quality evidence), calcium (RR 0.61, 95% CI 0.47 to 0.80; 13 studies; moderate-quality evidence), antiplatelet agents (RR 0.69, 95% CI 0.57 to 0.82; 31 studies; moderate-quality evidence), and antioxidants (RR 0.77, 95% CI 0.63 to 0.93; 25 studies; moderate-quality evidence). Calcium probably prevented PE (RR 0.63, 95% CI 0.46 to 0.86; 11 studies; moderate-quality evidence) and GHT (RR 0.89, 95% CI 0.84 to 0.95; 8 studies; high-quality evidence) in nulliparous/primigravida women. Few included studies for the outcome of superimposed preeclampsia were found.ConclusionAntiplatelet agents, calcium, and their combinations were most effective medications for preventing hypertensive disorders in high-risk pregnant women when compared with a placebo or no treatment. Any high-risk characteristics for women are important in deciding the best medications. The qualities of evidence were mostly rated to be moderate.Systematic review registrationPROSPERO CRD42018096276

Determinants of Pregnancy-Induced Hypertension among Mothers Attending Public Hospitals in Wolaita Zone, South Ethiopia: Findings from Unmatched Case-Control Study.

Background It has been estimated that approximately 14% of maternal death has resulted due to pregnancy-induced hypertension. Evidence also suggests that pregnancy-induced hypertension may result in adverse maternal and child outcomes. The aim of this study was to assess the determinants of pregnancy-induced hypertension among mothers attending antenatal and delivery services at public health hospitals in Wolaita zone, southern Ethiopia. Methods An institutionally based unmatched case-control study was conducted at three public hospitals. A total of 283 study participants were recruited for this study. Cases were selected consecutively as they were being diagnosed for pregnancy-induced hypertension, and two controls were selected for each case. Data were collected via the face-to-face interview technique using a pretested questionnaire. Unconditional logistic regression analysis was used to identify the independent predictor variables and produced odds ratio (OR) as a measure of association. Results The mean ± (SD) ages of cases and controls were 26.1 ± 5.4 and 26.1 ± 4.5 years, respectively. Being rural residents (AOR: 2.25, 95% CI: 1.09–4.65), illiterate (AOR: 3.12, 95% CI: 1.20–8.08), having the history of pregnancy-induced hypertension (AOR: 6.62, 95% CI: 2.48–17.71), history of kidney disease (AOR: 3.14, 95% CI: 1.05–9.38), and family history of hypertension (AOR: 5.59, 95% CI: 2.73–11.45) were determinants that increased the odds of suffering from hypertensive disorders of pregnancy. More importantly, eating vegetables and fruit reduces the odds of suffering from pregnancy-induced hypertension by 77% (AOR: 0.23, 95% CI: 0.06–0.79). Conclusion Being rural residents, illiterate, having a history of pregnancy-induced hypertension, and history of kidney disease, as well as the family history of hypertension were identified determinates of hypertensive disorders of pregnancy in the study area. Furthermore, fruit and vegetable intakes were identified as protective factors for pregnancy-induced hypertension. Therefore, early diagnosis and intervention of this disorder are warranted to reduce adverse outcomes.

Assessment of Prevalence of Hypertension in pregnant women with its Complications: A Cross Sectional Study

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [&lt;20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in &lt;20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.

THE MATCHED CASE CONTROL STUDY OF PREGNANCY HYPERTENSION PATIENTS AND THE NEONATAL BABY

Objective: To investigate the detection rate and effects of risk factors on gestational hypertension and the effect of maternal gestational hypertension on neonatal outcome. Design and method: This investigation study was proceeded on December 2013 -2014 November in Gansu Province maternal and child health hospital. The questionnaire covers the general situation of pregnant women and newborns, and describes the general characteristics of pregnancy-induced hypertension in Maternal and Child Health Hospital of Gansu Province. The first case-control study included pregnant women with pregnancy-induced hypertension as the case group.The second case-control study included mothers with a history of pregnancy-induced hypertension in the case of newborns.The second case-control study designed to explore the relationship between pregnancy-induced hypertension and newborns outcomes. Results: Of all 2143 pregnant women screened, 60 patients with pregnancy-induced hypertension were screened and the detection rate of pregnancy-induced hypertension was 2.7%. Univariate analysis showed that the weight gain during pregnancy was higher than normal, the age of less than 30 years old, and the two factors of pre-pregnancy BMI were related to the occurrence of hypertensive pregnancy. Multivariate logistic regression analysis showed that the weight gain during pregnancy was high in normal women. Pre-pregnancy BMI is a risk factor for gestational hypertension, age less than 30 years of age is the protective factor of gestational hypertension. Mothers with gestational hypertension may affect the growth and development of the newborns, newborns birth weight is low, pregnancy-induced hypertension newborns Apgar score lower than the control group. The study compared the data of newborns heart Doppler ultrasound, the study found that pregnant women with high blood pressure left ventricular ejection fraction lower than newborns who mother without pregnancy-induced hypertension. Conclusions: Pregnancy weight gain higher than normal, pre-pregnancy BMI is a risk factor for the occurrence of pregnancy hypertensive. Age less than 30 years is a protective factor of pregnancy-induced hypertension. Risk factors and protective factors of hypertension in pregnancy affect the occurrence and development of the disease.

Prevalence and Risk Factors of Pregnancy Induced Hypertension among Pregnant Mothers Attending Antenatal Care in Wachemo University, Nigist Eleni Mohammed Memorial Comprehensive and Specialized Hospital, Hadiya Zone, Southern Ethiopia: A Cross-Sectional Study

Introduction: The leading cause of maternal and perinatal morbidity and mortality is pregnancy-induced hypertension. In developed countries, it complicates 10% of all births. Pregnancy-induced hypertension kills half a million women per year, mainly in developing countries. The aim of this study was to determine whether antenatal care attendants in Nigist Eleni Mohammed Memorial Comprehensive and Specialized Hospital in Southern Ethiopia had pregnancy-induced hypertension. Methods: A hospital-based cross-sectional study was conducted in Wachemo University Nigist Eleni Mohammed Memorial comprehensive and specialized Hospital from December 30, 2020, to February 2021. Finally, via the systematic random sampling process, the study subjects were chosen from a chart review from June 2019 to May 2020. Bivariate and multivariate analyses were used to identify factors associated with pregnancy-induced hypertension. A P-value less than 0.05 were considered statistically significant. Results: The prevalence of Pregnancy-Induced Hypertension was 23.42% with 95% CI (21.8, 30.5). Age in years 25 to 35; (AOR=6.189; 95%CI; 2.232, 7.164), urban residence (AOR=2.103; 95%CI=1.046, 4.234), primigravida (AOR=2.6; 95%CI=1.642, 2.611), gestational age 20 to 37 weeks (AOR=5.278; 95%CI=1.852, 6.038) and past history of pregnancy induced hypertension (AOR=1.358; 95%CI; 1.756, 4.351) and past history of diabetes mellitus (AOR=7.344; 95%CI=1.344, 9.372)were statistically significant with Pregnancy-Induced Hypertension. Conclusion: In this study the prevalence of pregnancy-induced hypertension was high. Age, urban residence, primigravida, gestational age in weeks, history of pregnancy-induced hypertension, and history of Diabetes Mellitus were statistically significant with Pregnancy Induced Hypertension. To enhance maternal and child health, improving screening, treatment, and prevention strategies for PIH is necessary.

Maternal pregnancy-induced hypertension increases the subsequent risk of neonatal candidiasis: A nationwide population-based cohort study

ObjectiveNeonatal candidiasis is a leading infectious cause of significant morbidity and mortality in premature birth mainly due to impaired physical barriers and immature immune system of fetus. Maternal pregnancy-induced hypertension (PIH) has been reported to be able to disturb the neonatal immune system, which could cause the increased possibility of neonatal infection. Therefore, we hypothesized that maternal PIH may increase the risk of neonatal candidiasis. The aim of this study was to evaluate whether PIH increased the risk of neonatal candidiasis and identify the predictive risk factors. Materials and methodsPatients with newly diagnosed PIH between January 1, 2000, and December 31, 2013 were selected from the Taiwan National Health Insurance Research Database (NHIRD). For each patient in the PIH cohort, 4 subjects without PIH, matched for age and year of delivery, were randomly selected as the comparison cohort. A Cox proportional regression model was used to estimate the risks of neonatal candidiasis in both cohorts. ResultsAmong the 23.3 million individuals registered in the NHIRD, 29,013 patients with PIH and 116,052 matched controls were identified. Patients with PIH had a higher incidence of neonatal candidiasis than did those without PIH. According to the multivariate analysis, PIH (odds ratio [OR] = 2.08, 95% confidence interval [CI] = 1.11–3.19, p < 0.0228), single parity (OR = 1.91, 95% CI = 1.00–3.65, p < 0.0499), and preterm birth (OR = 3.57, 95% CI = 1.84–6.93, p = 0.0002) were independent risk factors for the development of neonatal candidiasis. ConclusionPatients who had a history of PIH was associated with an increased risk of having infants who develop neonatal candidiasis compared with those without PIH. Additionally, preterm birth was an independent risk factor for the development of neonatal candidiasis.

Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases.

Preeclampsia is a major cause of adverse maternal and perinatal outcomes, but how to identify women and fetuses at increased risk for later adverse events is a challenge. This study aimed to investigate the risk factors for adverse maternal and perinatal outcomes in women with preeclampsia. Data from 1396 women with preeclampsia were retrospectively collected and analyzed. Eighteen candidate risk factors and 12 adverse outcomes were investigated. The following factors were found to be significantly associated with at least one adverse outcome: maternal age 35 years or older, multiple birth, the usage of assisted reproductive technology, living in a rural area, history of pregnancy-induced hypertension, male fetus, multigravida, or having polycystic ovary syndrome, hemolysis, elevated liver enzymes, and low platelet count syndrome, intrahepatic cholestasis of pregnancy, cardiovascular disease, gestational diabetes mellitus, systemic lupus erythematosus, thyroid disease, or liver disease. Compared with patients without any identified risk factors, patients with preeclampsia with three or more risk factors were at increased risk for severe adverse outcomes. Those findings demonstrated that maternal risk factors could be used as indicators supplementary to clinical symptoms and laboratory test results for the risk assessment in women with preeclampsia.

Pregnancy Induced Hypertension and Associated Factors among Pregnant Women in Karamara Hospital, Jijiga, Eastern Ethiopia, 2015

Background: Pregnancy induced hypertension (PIH) is a significance rise of blood pressure during pregnancy, occurring after 20 weeks. It includes gestational hypertension, mild pre-eclampsia , sever pre-eclampsia and eclampsia. So more, women with PIH disorders may progress from mild diseases to more serious conditions. This study assessed pregnancy induced hypertension and associated factors among pregnant women. Methods: A hospital based cross- sectional study design was conducted in Karamara hospital, Jijiga town among 408 pregnant. Systematic random sampling was employed. The data was collected using pretested semi-structured questionnaire and analyzed using SPSS Version 20. Results: The prevalence of pregnancy induced hypertension was 19.1% in Karamara hospital. Maternal education (AOR=2.5, 95% CI%=1.2-5.3), age (AOR=2.73, 95% CI=1.31-5.7), previous history of preeclampsia (AOR=19.3, 95% CI%=5.2-72.1) and family history of preeclampsia (AOR=7.2, 95% CI%=2.9-17.8) were identified as predictor factors for occurrence of pregnancy induced hypertension. Conclusion and recommendations: One out of five women developed pregnancy induced hypertension in Karamara referral Hospital, Jigjiga Ethiopia. This is figure is very high compared to studies conducted in Ethiopia. Socio-demographic factors like age less than 25 years, lack formal education, previous history of PIH and family history of PIH were independent predictors of development of pregnancy induced hypertension. Hence, this study suggests that early detection and management of mothers with PIH should be mandatory as part of focused antenatal care. Lastly, this study suggests that further studies should be conducted to assess lifestyle and dietary factors, using analytical study designs.

Maternal predictors of low birth weights: Audit of data of delivery room register at a Tertiary Health Center of Sub-Himalayan Region

Background: Birth weight is an indicator of social and economic development of any country. It predicts the status of women of country and the resources invested in them so that they deliver healthy child. The proportion of low birth weight (LBW) has reduced in India in the past few decades; however, we have still a long way to go. Objective: We aimed to conduct an audit of retrospective data from the records of labor room of a Tertiary Care Center of Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh. Methodology: A retrospective data mining of records of the labor room wards (delivery rooms) was conducted from January to June 2016 at Tertiary Care Center of Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh. LBW was our outcome of interest. Results: Out of the total 3738 deliveries conducted, 1251 (33.46%) of babies born were LBW, and there were 100 intrauterine deaths and 12 stillbirths with a total of 112 (2.9%) deaths. Age, height of mother, backward caste, history of pregnancy-induced hypertension, preterm delivery, one living child of mother, multiple fetuses, and cesarean section in current pregnancy were significant predictors after controlling for confounders. Conclusion: The higher proportion of LBW in tertiary center as compared to state-level data shows that secondary prevention in the form of early identification of high-risk cases, and timely referral to higher centers is functioning well in this part of the country. However, the community-based primary prevention efforts are still given a low preference.

Abstract P274: Pregnancy-induced-hypertension and the Risk of Postpartum Hypertension Among Gestational Diabetes Women

Background: Previous studies in the general people indicated that pregnancy-induced hypertension (PIH) increased the risk of subsequent hypertension after delivery. Some studies found that women with gestational diabetes mellitus (GDM) had an increased risk of PIH. However, very few studies have assessed the association between PIH and the risk of postpartum hypertension among GDM women. Aims: To evaluate the association between PIH and the risk of postpartum hypertension among GDM women. Methods: We performed a retrospective cohort study in 1261 GDM mother at 1-5 years after delivery using the baseline data from Tianjin Gestational Diabetes Mellitus Prevention Program. Cox regression models were applied to assess the single and joint associations of having a history of PIH, maternal pre-pregnancy BMI (normal weight, overweight and obesity), and weight change from pre-pregnancy to postpartum with the risk of subsequent hypertension among the GDM women. Results: GDM people with a history of PIH, high pre-pregnancy BMI, and weight gain more than 7 kg from pre-pregnancy to postpartum were associated with an increased risk of postpartum hypertension. Joint effects analysis revealed that the positive association between a history of PIH in the index pregnancy and the risk of postpartum hypertension was consistent in GDM women with different levels of pre-pregnancy BMI or weight gain from pre-pregnancy to postpartum. Conclusion: A history of PIH increases the risk of subsequent hypertension in postpartum 1-5 years among GDM women. We suggest highlight the pregnancy guide in different stages and pay more attention on this group of people.

Risk factors of hypertensive disorders among Chinese pregnant women.

The prevalence of hypertensive disorders in China was much higher than that in the United States. Considering the large population with wide geographic area of China, we aimed to add more information regarding the risk factors for hypertensive disorders of pregnancy. A case-control study was performed on 373 hypertensive cases and 507 normotensive controls. Participants were recruited from 2008 to 2014 in Yichang Maternal and Child Health Care Center in Hubei province and Anyang Maternal and Child Health Care Hospital in Henan province, China. Socio-demographic factors, family- related factors, pregnancy-associated factors, factors related to daily life behaviors and psychosocial factors were investigated with respect to hypertensive disorders in pregnancy through well-designed questionnaire. Chi-square test, t-test, univariate logistic regression analysis, and multivariate logistic regression analysis were used to find the possible risk factors behind hypertensive disorders in pregnancy. The results showed that family history of cardiovascular diseases (OR=6.18, 95% CI, 2.37 to 16.14), history of pregnancy-induced hypertension (OR=16.64, 95% CI, 5.74 to 48.22), low maternal educational level (OR=2.81, 95% CI, 1.30 to 6.04), and poor relationship with their parents-in-law (OR=3.44, 95% CI, 1.55 to 7.59) had statistically significant associations with hypertensive disorders in pregnancy through multivariate logistic regression analysis. Increased maternal age, increased pre-pregnancy body mass index, living in rural area, low paternal education level, family history of hypertension, passive smoking one year before and/or in pregnancy, and poor sleeping quality were significantly associated with hypertensive disorders in pregnancy from univariate logistic regression analysis while the associations became uncertain when they were entered for multivariate logistic regression analysis. It was concluded that family history of cardiovascular diseases, history of pregnancy-induced hypertension, low maternal educational level, and poor relationship with their parents-in-law were independent risk factors for hypertensive disorders among Chinese pregnant women.

Pregnancy-induced hypertension and associated factors among pregnant women attending public health facilities in Swaziland

Background/Aims: Pregnancy-induced hypertension is the main cause of morbidity and mortality among pregnant women in Swaziland. The main objectives of this study were to: i) identify the factors contributing to the development of pregnancy-induced hypertension among women attending public health facilities in Swaziland; ii) investigate the association between the development of pregnancy-induced hypertension sociodemographic variables, family history, obstetric history, lifestyle, and access to health care services. Methods: An exploratory, descriptive research design, using a quantitative research approach was used. Data were analysed using SPSS version 20, where a sample frame of 60 women diagnosed with pregnancy-induced hypertension, and a sample of 50 women was selected using simple random sampling. Results: The findings revealed a significant association between sociodemographic variables and obstetric history (p=0.001), marital status (p=0.025) and lifestyle, which in turn predisposes the woman to pregnancy-induced hypertension. Employment status (p=0.044) was significantly associated with access to health care services and level of education (p=0.027). Conclusions: Factors that are significantly associated with the development of pregnancy-induced hypertension include age, multiple pregnancy, a history of pregnancy-induced hypertension in previous pregnancies and limited use of antenatal care services. The authors recommend strengthening pre- and in-service midwifery education on the management of pregnancy-induced hypertension, as well as client education on the risk factors for pregnancy-induced hypertension.

Legal Briefs: Compression of Umbilical Cord or a Cord Accident?

A 2,818-g, 395/7 weeks’ gestation, female infant was born to a 27-year-old, gravida 1, para 0 mother with a history of pregnancy-induced hypertension and oligohydramnios. Labor was augmented by oxytocin because of the hypertension. The nurses notified the obstetrician about several variable decelerations during the first stage of labor and later about the development of minimal variability of the fetal heart rate (FHR), but he ordered the continuation of oxytocin. At 7-cm dilation, spontaneous rupture of the membranes occurred and labor progressed, with cervical dilation to 9 cm within 30 minutes. During the next 20 minutes, several variable decelerations followed, and the use of oxytocin was discontinued. However, more and deeper variable decelerations occurred, with one prolonged for several minutes. The fetus was being externally monitored, and the tracings were difficult to interpret and at some points totally unreadable. The defending and defense obstetricians pointed out in their depositions that accelerations were present, and therefore it was a reassuring tracing. The plaintiff obstetric expert thought the tracings were not of sufficient quality to be interpreted accurately and that cesarean delivery should have been performed because intolerance of labor during the first stage could predict difficulties during the second stage. At 9-cm dilation, the obstetrician ruptured the forebag and thick meconium was released; therefore, he decided to perform an amnioinfusion. As soon as the catheter was introduced, fetal bradycardia began. The obstetrician proceeded with the amnioinfusion and placed a scalp electrode on the fetus during the bradycardia. The plaintiff obstetrician contended that amnioinfusion was inappropriate, especially because the fetus was entering the second stage of labor, should not to be used during bradycardia, and, most importantly, delayed the delivery. He thought some of the decelerations were a combination of late and variable decelerations before the terminal bradycardia. The …

Pregnancy-induced hypertension is associated with an increase in the prevalence of cardiovascular disease risk factors in Japanese women

This study assessed whether pregnancy-induced hypertension (PIH) affects the prevalence of cardiovascular disease (CVD) risk factors in later life among Japanese women. Study participants were 1,185 women (mean [SD] age, 46.5 [5.6] y; range, 38-73 y) aged 40 years or older who underwent a health checkup at a periodic health examination facility between January 2012 and December 2013 and had experienced giving birth. Questionnaires were sent to potential participants, and they were encouraged to provide their Maternal and Child Health Handbook (handbook). We recruited 101 women with a history of PIH (PIH group) and 1,084 women with uncomplicated pregnancy at delivery (control group). Groupings were based on information from the handbook. We assessed the association between PIH and CVD in later life among Japanese women by focusing on hypertension, diabetes mellitus, and dyslipidemia as risk factors for CVD. Odds ratios (ORs) for the use of antihypertensive, diabetes mellitus, and dyslipidemic medications in the PIH group were determined. Women with PIH had increased risk of antihypertensive medication use compared with women without PIH (2.9% vs 13.9%; OR, 4.28; 95% CI, 2.14-8.57). Triglycerides were significantly higher and high-density lipoprotein cholesterol was significantly lower in the PIH group than in the control group. The OR for dyslipidemic medication use in the PIH group relative to the control group was 3.20 (95% CI, 1.42-7.22). Our findings suggest that a history of PIH may be associated with an increased risk of hypertension (a risk factor for CVD) in later life among Japanese women.