Previous History Of Preeclampsia Research Articles

Prevalence and Risk Factors Associated With Gestational Diabetes Mellitus Among Pregnant Women: A Cross-Sectional Study in Ghana.

Gestational diabetes mellitus (GDM) is a global public health issue that have serious consequences on mother and her child's health. However, limited data is available on the prevalence of GDM and its associated risk factors in Ghana. This study investigated the prevalence and associated risk factors of GDM among women attending selected antenatal clinics in Kumasi, Ghana. This cross-sectional study included 200 pregnant women who attended antenatal clinics from Three-selected health facilities in the Ashanti Region, Ghana. Women already diagnosed of GDM were identified through their medical records and were confirmed based on the criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG), which uses a fasting blood glucose of ≥ 5.1 mmol/L. A well-structured questionnaire was used to collect data on socio-demographic, obstetric, clinical and lifestyle risk factors. Multivariate logistic regression models were used to determine the independent risk factors of GDM. The overall prevalence of GDM among study participants was 8.5%. GDM was prevalent among age 26 and 30 years (41.2%), married participants (94.1%) with basic education (41.2%) and being Akan by ethnicity (52.9%). Previous history of oral contraceptive use (aOR: 13.05; 95% CI: 1.43-119.23, p=0.023), previous history of preeclampsia (aOR: 19.30; 95% CI: 2.15-71.63; p=0.013) and intake of soda drinks (aOR: 10.05, 95% CI: 1.19-84.73, p=0.034) were found to be independent risk factors of GDM. The prevalence of GDM was found to be 8.5% and this was associated with the previous use of oral contraceptives, history of preeclampsia and intake of soda drinks. Public health education and dietary lifestyle modification may be required for pregnant women who are at risk of GDM.

Risk factors of preeclampsia among pregnant women admitted at labor ward of public hospitals, low income country of Ethiopia; case control study.

Preeclampsia is a pregnancy-specific, multisystem disorder of unknown etiology, which characterized by new onset of high blood pressure & proteinuria after 20weeks of gestation. Globally, it contributes 76,000 maternal deaths, 500,000 infant deaths annually, and the second common cause of maternal deaths. In Ethiopia, 19% of maternal deaths result from hypertensive disorder of Pregnancy. To assess the risk factors of preeclampsia among pregnant women admitted in labor ward of Public hospitals, Amhara Region Ethiopia, METHODS: A facility based unmatched case-control study design was conducted in two public hospitals of North Wollo Zone. Cases were pregnant women, who had confirmed diagnosis of preeclampsia, controls were those who had no evidence of preeclampsia, and 65 cases and 195 controls were selected by convenience and systematic random sampling techniques respectively. The collected data was interred in to in EPI INFO version 7.1, transferred, and analyzed using SPSS version 20.00 statistical software. Multivariate logistic regression was used to identify independent variables. Factors with P-value<0.05 were taken as statistically significant of pre-eclampsia among pregnant women. All of the respondents of cases and controls were participated in the study. Factors associated with preeclampsia were respondents who had read and write (AOR=3.22, 95% CI: (1.05-9.84)) and attended primary school [AOR=7.02, 95% CI: (1.57-31.45)]. Those pregnant women, who had at least two ANC visit [AOR=8.69, 95%CI: (1.43-52.85)] and those who had three visit [AOR=12.59, 95%CI: (3.06-56.05)]. In addition to these, birth Interval less than 24month [AOR=4.09, 95% CI: (1.33-12.61)]. Birth Interval 24-35month [AOR=2.53, 95% CI: (1.38-11.87], respondents with family history of HPN (AOR=5.93, 95%CI: (2.39-14.67), family history of DM [AOR=2.15, 95%CI: (1.12-6.98)], and respondents with previous history of preeclampsia (AOR=4.14 95%CI: (1.66-10.33) were identified significant factors of preeclampsia among pregnant women attended in labour ward. Educational status, antenatal care, lower birth interval, having family history of chronic HPN and DM, and history of preeclampsia were identified as major risk factors for occurrence of preeclampsia. Early detection of cases and intensive screening of pregnant women in every visit should be done and large-scale study will be done to identify other risk factors of preeclampsia.

Determinants of preeclampsia among mothers attending perinatal care in Gurage zone public hospitals, Ethiopia, matched case control study

BackgroundPreeclampsia is the commonest and most serious type of hypertensive disorder during pregnancy. It is the cause of 10% – 15% of maternal death worldwide. Though maternal mortality in Ethiopia is decreasing, deaths related to pregnancy-induced hypertension is increasing. Identifying the factors associated with preeclampsia helps reduce the incidence of the disease and its adverse outcomes. Therefore, this study aims to assess determinants of preeclampsia among mothers attending perinatal care in Gurage zone public hospitals, Ethiopia, 2020. MethodInstitution-based matched case-control study design was used to assess determinants of preeclampsia among 426 mothers, 142 cases, and 284 controls. The study was conducted in three public hospitals in Gurage Zone. Cases were preeclamptic mothers and Controls were non-preeclamptic mothers. EPI INFO was used to enter the data and then SPSS was used to analyze the data. Bivariate and multivariate logistic regression was used. ResultSignificantly associated factors on multivariate analysis in this study are nulliparity with AOR 3.81; 95% CI (1.55,9.34); multiplicity of pregnancy AOR 3.62; 95%CI (1.08,12.13) having preeclampsia history AOR 10.11; 95%CI (4.06, 25.21); parents history of hypertension had AOR 2.95; 95%CI; (1.11,7.68); and drinking alcohol AOR 4.42; 95%CI (2.15,9.08) ConclusionIn this study determinants’ of preeclampsia are nulliparity, multiplicity of pregnancy, previous history of preeclampsia, family history of hypertension, and alcohol consumption. Providing health education about risk factors of preeclampsia, early initiation, and increased frequency of antenatal follow-up will help early identification of these risk factors, diagnosis of preeclampsia, and preventing its complications.

Acute kidney injury secondary to obstetric complications in the third trimester of pregnancy and the puerperium

Background Acute kidney injury (AKI) in pregnancy is still a frequent health problem in developing countries. The aim of our study is to assess the prevalence and outcome of AKI secondary to obstetric complications during the third trimester of pregnancy and the puerperium Patients and methods A retrospective study conducted on 80 patients presented with AKI secondary to obstetric complications during the third trimester of pregnancy and the puerperium. All patients were recruited from the National Institute of Nephrology and Urology in Cairo during the period from June 2014 to June 2016. Data was collected from the unit database and patient medical charts including patient's history and examination findings during admission, laboratory parameters on admission including complete blood count and routine chemistry, hospital course, treatment received including renal replacement therapy and maternal and fetal outcomes. Results Our observational study included 80 patients presented with AKI during late pregnancy and the puerperium. Mean maternal age was 32±6 years and mean gestational age at presentation was 27±9 weeks. Mean serum creatinine was 7.7±2.4 mg/dl. Most of the patients who developed AKI did not receive antenatal care 67.5% (n=54). Also, more than half of the patients had a previous history of preeclampsia 52.5% (n=42). The median duration of hospital stay was 13 (6–51 interquartile range) days. Five (6%) patients underwent renal biopsy; 55 (69%) patients received hemodialysis as a renal replacement therapy while five patients received plasma exchange. The main etiology of AKI in our study was ischemic acute tubular necrosis 50% (n=40). Five (8%) patients developed chronic kidney disease and three patients (4%) progressed to end-stage renal disease. Maternal mortality was 4% (n=3) and fetal mortality was 74% (59 fetus). Conclusion AKI in late pregnancy and puerperium still presents as a health problem in developing countries. Most patients with AKI had a history of preeclampsia. Also, most of them had not received proper antenatal care. Improvement of the antenatal care is crucial for early detection and prevention of such problems.

The effect of hormonal contraceptive on low birth weight baby delivery in Agronursing Area

Babies born with low birth weight (LBW) have a high risk and will have an impact on subsequent development. Studies show that the use of hormonal contraceptives can increase the risk of experiencing subjective health complaints than non-hormonal contraceptives. The study is an analytical descriptive study that aims to identify the effect of hormonal contraceptive used on low birth weight baby delivery. The study was conducted in three agricultural hospitals and three public hospitals in the Agriculture area of Besuki Residency. Data analysis of the sample was carried out by quota sampling. Characteristics of respondents were displayed by univariate analysis. The total number of participants in this study were 441 participants. Participants were divided into several data categories such as age, parity, medical history, previous history of preeclampsia, low birth weight babies, contraceptives used, complications of premature rupture of membranes. There two factors, that can predict the low birth weight baby delivery. They are hormonal contraceptives use and premature rupture of membranes. The test results get the hormonal contraceptive used factor to be the strongest factor (OR 19,12). Thus it was concluded "the hormonal contraceptive used factor is an abdominal factor of low birth weight baby delivery with a significance value of 0.000 (p0.05).

Comparative analysis of high risk factors between early-onset pre-eclampsia and late-onset pre-eclampsia

Objective: To explore the difference of high-risk factors between early-onset and late-onset pre-eclampsia, and to further understand high-risk factors of pre-eclampsia. Methods: Clinical data of pre-eclampsia pregnant women in 160 medical institutions in China in 2018 were retrospectively analyzed, including 8 031 cases of early-onset pre-eclampsia and 12 969 cases of late-onset pre-eclampsia. The proportion of high-risk factors, different body mass index (BMI) and age stratification between early-onset group and late-onset group were compared. Results: (1) Univariate analysis of high-risk factors: the proportions of high-risk factors in early-onset group and late-onset group were compared, and the differences were statistically significant (all P<0.05). Among them, the proportions of primipara and multiple pregnancy in early-onset group were lower than those in late-onset group, while the proportions of pregnant women with advanced age, irregular antenatal examination, obesity, family history of hypertension, pre-eclampsia, diabetes, kidney diseases, immune system diseases and assisted reproductive technology were higher than those in late-onset group. (2) Hierarchical analysis of BMI: the proportion of pregnant women with BMI≥24 kg/m2 in early-onset group [48.2% (2 828/5 872) vs 45.5% (4 177/9 181), respectively; P=0.001] and the proportion of pregnant women with BMI ≥28 kg/m2 in early-onset group [19.5% (1 143/5 872) vs 18.0% (1 656/9 181), respectively; P=0.028] were significantly higher than those in late-onset group. (3) Age stratification analysis: the proportion of pregnant women aged 35-39 years in the early-onset group [21.8% (1 748/8 023) vs 17.5% (2 110/12 068), respectively; P<0.01], the proportion of pregnant women 40-44 years old [6.8% (544/8 023) vs 5.4% (648/12 068), respectively; P<0.01], and the proportion of pregnant women ≥45 years old [0.7% (58/8 023) vs 0.5% (57/12 068), respectively; P=0.021] were significantly higher than those in the late-onset group. (4) Multivariate analysis: advanced age (≥35 years old), multiple pregnancy, irregular antenatal examination or transfer from other hospitals, family history of hypertension (including paternal, maternal and parental lines), previous history of pre-eclampsia, kidney diseases, immune system diseases (systemic lupus erythematosus, antiphospholipid antibody syndrome) and assisted reproductive technology pregnancy were the risk factors affecting the severity of pre-eclampsia (all P<0.05). Conclusion: Pregnant women with high risk factors such as age ≥35 years old, BMI ≥24 kg/m2 before pregnancy, family history of hypertension, history of pre-eclampsia, chronic kidney diseases, immune diseases (mainly including systemic lupus erythematosus and antiphospholipid syndrome) and assisted reproductive technology are more likely to have early-onset pre-eclampsia.

Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

Risk Factor Prevalence of Late Onset Preeclampsia in Dr. Soetomo General Hospital Surabaya

Introduction: Preeclampsia is a condition of hypertension that occurs after 20 weeks of gestation, followed by the detection of protein in the urine sample, and is one of the major causes of maternal mortality. It is categorized, based on time of gestation, into 2-stage are early and late-onset. One of the more accessible tools in diagnosing and also preventing preeclampsia is by its risk factors. The aim of this study was to observe the appearance of some of the risk factors in patients with late-onset preeclampsia and to allow a better approach in patients with said comorbidities.Methods: This was a descriptive observational study. The sample used was 35 patients diagnosed with late-onset preeclampsia in Dr. Soetomo General Hospital Surabaya from January to December 2016.Results: Among 35 patients diagnosed with late-onset preeclampsia, obesity (65.71%) appeared the most. Maternal age (37.15%) and primigravida (28.57%) appeared in second and third places. Chronic hypertension appeared only in 6 (17.14%) patients, whereas multiple pregnancies appeared in 3 (8.57%). Both patients with a history of previous preeclampsia and diabetes mellitus only appeared once (2.86%).Conclusion: Obesity has the most appearance in patients with late-onset preeclampsia, followed by maternal age and primigravida.

RELATIONSHIP BETWEEN OBESITY, TWIN-PREGNANCY AND PREVIOUS HISTORY OF PREECLAMPSIA WITH PREECLAMPSIA

Background: Preeclampsia can threaten the health of the mother and fetus during pregnancy and childbirth, besides that it also increases the risk of long-term complications and has the potential to cause death. The incidence of preeclampsia at the RSUD Engku Haji Daud Tanjung Uban showed an increase in the last three years, namely the occurrence from 2017 as many as 23 cases to 56 cases in 2019. The condition of preeclampsia can worsen quickly and without warning, for that, it must be detected and managed appropriately. This study aimed to identify the association of obesity, multiple pregnancies, and previous history of preeclampsia with the incidence of preeclampsia in maternity women. Methods: This study uses a case-control study design. Performed on women giving birth in the period January – December 2019, consisting of 56 cases and 112 controls. Maternal women with preeclampsia were cases and women who were not diagnosed with preeclampsia were controls. The data was obtained from the respondents' medical records, then analyzed using the Chi-Square test or Fisher's Exact test with a value of = 0,05. Results: Obesity was associated with an increased risk of preeclampsia (OR= 4,746, 95% CI 2,381-9,460; P=0,000). Multiple pregnancies were associated with a significantly increased risk of preeclampsia (OR=15,857, 95% CI 1,899-132,384; P=0,002). Likewise, a previous history of preeclampsia was associated with a markedly increased risk of preeclampsia (OR=99,000, 95% CI 22,057-444,343; P=0,000). Conclusion: Based on these data, it was found that obesity, multiple pregnancies, and previous history of preeclampsia were significant risk factors for the occurrence of preeclampsia. It is important to identify risk factors for preeclampsia early, so that appropriate management can be carried out, to prevent complications.

Histologic Chorioamnionitis in Pregnancies Complicated by Preeclampsia and the Effect on Neonatal Outcomes.

Histological chorioamnionitis (HC) is a common placental finding that represents acute/chronic inflammation and can affect neonatal outcomes. We aimed to examine the effect of HC on neonatal outcomes in pregnancies complicated by preeclampsia. All pregnancies with the diagnosis of preeclampsia at 24-42weeks between 2008 and 2019 were reviewed. Placental lesions were classified according to the "Amsterdam" criteria. Composite adverse neonatal outcome included ≥1 early complication. Maternal and neonatal outcomes were compared between cases with and without HC. Multivariable regression analysis was performed to identify independent associations with adverse neonatal outcome. Compared to preeclampsia without HC (n=517), preeclampsia with HC (n=55) was characterized by a more advanced gestational age (p<0.001) and a higher rate of nulliparity (p=0.02). Diabetes was more prevalent in preeclampsia without HC (p=0.039) as was a history of previous preeclampsia (p=0.048). Neonates in the preeclampsia with HC group had higher rates of adverse neonatal outcome (p<0.001) and Apgar scores <7 at 5min (p=0.034) despite a higher birthweight (p=0.005). Preeclampsia without HC was associated with smaller placentas and a higher rate of placental maternal vascular malperfusion lesions (p=0.014 and p<0.001 respectively). By multivariate analysis, gestational age and HC were independently associated with adverse neonatal outcome (aOR 0.88 95% CI 0.76-0.96, and aOR 1.33, 95% CI 1.11-3.09, respectively). In preeclampsia, concomitant HC was associated with adverse neonatal outcome despite a more advanced gestational age and higher neonatal birthweight. This inflammatory mechanism probably plays a role in a more severe subgroup of preeclampsia cases, causing an additional risk for the developing fetus.

Comparing the first trimester and second trimester fifty grams oral glucose tolerance test values in gestational diabetes mellitus

Objective: The present study aimed to assess the results of pregnant women who have been applied a 50 g oral glucose tolerance test (OGTT) in the first and second trimesters and investigate this method’s role in the diagnosis of gestational diabetes mellitus (GDM) and risk factors associated with this disease. Material and Methods: This retrospective study was performed on 153 pregnant women who were admitted to our hospital’s antenatal clinics between March 2011 and August 2011. Fifty grams OGTT was applied to the same pregnant women both in the 1st trimester (between 8th and 14th weeks) and second trimester (between 24th and 28th weeks); values of the test results were then compared. A 100 g OGTT di- agnostic test was performed on those with a 50 g OGTT value of ≥140 mg/dl in both trimesters. The study patients were divided into two groups as non-GDM and GDM based on venous plasma glucose values measured 1 h after 50 g of oral glucose load given. The non-GDM group consisted of those with plasma glucose levels &lt;140 mg/ dl and plasma glucose levels between 140 mg/dl and 200mg/dl, GDM group plasma glucose levels ≥200 mg/dl. First trimester and second-trimester OGTT values and possible risk factors for GDM (age, gravida, parity, number of abortions, smoking, a previous GDM history, etc.) were compared between non-GDM and GDM groups. Results: GDM, diagnosed in 4.5% (7) in the first trimester (between 8th and 14th weeks) and 6.5% (10) second trimester, was detected in 11% (17) of 153 pregnant women in the present study. GDM, diagnosed in 41.2% (7 patients) in the first trimester and 58.8% (10 patients) second trimester, was found with a higher rate in pregnant women over 30 years (p=0.000 &lt;0.05). The mean fasting blood glucose (FBG) level was 96 mg/dl in the GDM group and 83 mg/dl in the non-GDM group, with a statistically sig- nificant difference, which existed (p&lt;0.05). The mean 50 g OGTT value was 170 mg/ dl in pregnant women diagnosed with GDM in the first trimester, and it was 140 mg/dl in those diagnosed in the second trimester, with this difference was considered statis- tically different (p&lt;0.05). Age, parity, a family history of DM, FBG, a previous GDM his- tory, gravida, a previous macrosomia history, and a previous history of preeclampsia were determined as risk factors that significantly increase the risk of GDM (p&lt;0.05). The half of patients was diagnosed with GDM in the early period of pregnancy. In the present study, 41.2% of cases were diagnosed in the first trimester and 58.8% in the second trimester. In general, the patients diagnosed in the first trimester were those being under risk in terms of GDM. According to the present study, it is recommended that the pregnant women should be scanned for GDM in the early period. Conclusion: With screening tests to be applied to risky groups in early pregnancy, a significant number of cases with GDM recently be detected on time. Thereby, mater- nal and fetal morbidity and mortality rates might be considerably reduced thanks to providing proper treatments and regular monitoring. Furthermore, for obtaining spe- cific data concerning the factors with potential influence on the risk of GDM, further studies on this topic need to be performed.

Severe preeclampsia is associated with postpartum diastolic dysfunction and non-dipping blood pressure profile pattern

Abstract Background Left ventricular diastolic dysfunction and non-dipping profile, detected by ambulatory blood pressure monitoring (ABPM), are two features recorded to be associated with sustained hypertension. Both are predictors of an increased cardiovascular morbidity later in life. Complete normalization of blood pressure (BP) in preeclampsia is detected over a variable period of time. Methods A prospective cohort study was conducted in a tertiary university hospital including normotensive women with a history of preeclampsia in the current pregnancy enrolled within the first week postpartum. All cases were subjected to 24 h-ABPM and 2D trans-thoracic echocardiography three months post postpartum concomitantly with a clinical evaluation. Chi2-test was used to compare the qualitative data while student t-test was used to compare the quantitative data. Multivariate regression analysis was used for prediction of non-dippers and diastolic dysfunction in our cohort. Results Hundred twenty eight women were included in the study. Their mean age was 28.6±5.1 years and the mean basal BP was 123.1±6.4/74.6±5.9 mm Hg. Out of the studied women, 90 (70.3%) women were dippers and 38 (29.7%) women were non-dippers. It was noticed that diastolic dysfunction was presented in 28 (73.7%) of non-dippers while none of dippers had diastolic dysfunction. Women with severe preeclampsia had higher frequency of non-dipper (35.5% vs. 24.2%; P=0.02) and diastolic dysfunction (29% vs. 15%; P=0.01) in comparison to those women with mild preeclampsia. Severe preeclampsia and previous history of preeclampsia were significant predictors for non-dipping status (OR=1.1, 95% CI: 0.05–10.56 and 1.4, 95% CI: 0.30–4.26 respectively, R2 = 0.7; P&amp;lt;0.001). They were also predictors for diastolic dysfunction in our studied population (OR = 1.6, 95% CI: 1.1–2.2 and 1.3, 95% CI: 1.2–2.2 respectively, R2 = 0.6; P&amp;lt;0.05). Conclusion Women with a history of preeclampsia have the risk for developing cardiovascular events later in life. The severity and recurrence of preeclampsia were significant predictors for both non-dipping profile and diastolic dysfunction. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Orman Heart Hospital-Assiut University; Women Health Hospital-Assiut University

Ultrasonografía Doppler de arterias uterinas como predictor de preeclampsia y de resultados adversos maternos y perinatales

IntroductionDoppler ultrasound is a very useful tool for measuring the flow of uterine arteries in the second trimester of pregnancy ObjectiveDetermining the relationship between maternal and perinatal adverse outcomes with those found in the Doppler of uterine arteries, and to identify in which risk groups this constitutes a better predictor of preeclampsia. MethodObservational, descriptive and prospective study, with a longitudinal cut. The sample consisted of 243 patients with risk factors, and divided into two groups according to the normal or pathological outcome of the Doppler at 20 and 26 weeks. Inferential statistics and parameter estimation test were performed. ResultsIn the pathological Doppler group there was increased incidence of retro-placental haematoma, preterm delivery, intrauterine growth restriction, and caesarean section, showing high specificity to rule out adverse events. The risk groups most benefited from uterine artery Doppler were autoimmune diseases and previous history of preeclampsia. ConclusionsThe Doppler of uterine arteries in the second trimester is a useful test in the prediction of preeclampsia and its maternal- perinatal complications in high-risk patients.

Prevalence and Associated Factors of Pre-eclampsia among Pregnant Women at Antenatal Booking in the Halaba Kullito General Hospital, Southern Ethiopia.

Background: Pre-eclampsia is a multi-system hypertensive disorder specific to pregnancy. It is one of the leading causes of maternal, foetal and neonatal morbidity and mortality worldwide particularly, in developing countries. However, in Ethiopia there is a paucity of information on the prevalence and determinants of pre-eclampsia. Hence, this study aimed to assess the prevalence and associated factors of pre-eclampsia among pregnant women at antenatal booking in the Halaba Kullito General Hospital,Southern Ethiopia. Method: This a hospital-based cross-sectional was conducted on 242 women using systematic sampling technique during February 1-28, 2019. Data were collected using a pre-tested, structured interviewer-administered questionnaire and chart review, which was performed to obtain women’s medical information and laboratory test results that could not be acquired by the interview. Data were entered into EpiData (version 3.1) and analyzed using SPSS (version 24). Both bivariate and multiple variable logistic regression analysis were computed. Odds ratio with their 95% confidence intervals (CI) were calculated to measure the strength of the association between the outcome and the independent variables. P-value <0.05 was considered as a statistically significant. Results: In the study setting, the prevalence of pre-eclampsia was observed to be 9.9%. Previous history of pre-eclampsia [AOR=8.9, 95% CI (1.03, 16.61], gestational diabetes mellitus [AOR=5.8, (1.38, 17.54)] and twin pregnancy [AOR=1.72, 95% CI (1.05, 3.71)] were associated factors of pre-eclampsia. Conclusions: A considerable proportion of pregnant women were experienced pre-eclampsia. Previous history of pre-eclampsia, gestational diabetes mellitus and multiple gestations were associated factors of pre-eclampsia. Therefore, the finding suggests that health care providers and other stakeholders should use these risk factors as a screening mechanism for the timely identification and management of pre-eclampsia by regular antenatal monitoring and careful follow-up.

Prevalence and determinants of hypertensive disorders of pregnancy in Ethiopia: A systematic review and meta-analysis.

IntroductionHypertensive disorder of pregnancy is the second commonest causes of maternal death globally. Different public health studies were conducted on hypertensive disorder of pregnancy which presented inconsistent result. Therefore, this systematic review and meta-analysis was commenced to summarize the findings conducted in several parts of the country and to generate the nationwide representative data on the prevalence and risk factors of hypertensive disorder of pregnancy in Ethiopia.Methods and materialsElectronic databases such as PubMed, Scopus, Google Scholar, Hinari, and African Journals Online were searched for studies published in English up to March, 2020. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and Newcastle-Ottawa Scale were used for data extraction and quality assessment of the included studies. The meta- regression analysis was computed at 95% CI to present the pooled prevalence and risk factors of hypertensive disorder of pregnancy.ResultsThirty four studies were included in this systematic review and meta-analysis. The pooled prevalence of hypertensive disorder of pregnancy and preeclampsia in Ethiopia were 6.82% (95% CI (5.90, 7.74)) and 4.74% (95% CI (3.99, 5.49)) respectively. Maternal age ≥35 years (Adjusted Odds Ratio (AOR): 2.91 (95% CI: 1.60, 5.26)), twin pregnancy (AOR: 3.04 (95% CI: 1.89, 4.87)), previous history of preeclampsia (AOR: 5.36 (95% CI: 3.37, 8.53)), family history of hypertension (AOR: 4.01 (95% CI: 2.65, 6.07)), family history of diabetes mellitus (AOR: 3.07 (95% CI: 1.66, 7.70)), body mass index ≥25 (AOR: 3.92 (95% CI: 1.82, 8.42)), alcohol consumption (AOR: 1.77 (95% CI: 1.11, 2.83)), urinary tract infection (AOR: 4.57 (95% CI: 3.47, 6.02)), lack of nutritional counseling during antenatal period (AOR: 4.87 (95% CI: 3.36, 7.06)), lack of fruits (AOR: 3.49 (95% CI: 2.29, 5.30)), and vegetables consumption (AOR: 2.94 (95% CI: 2.01, 4.31)) were the risk factors of hypertensive disorder of pregnancy in Ethiopia.ConclusionsThe pooled prevalence of hypertensive disorder of pregnancy is relatively higher compared with the previous reports. Maternal age ≥35 years, twin pregnancy, previous history of preeclampsia, family history of hypertension, family history of diabetes mellitus, body mass index ≥25, alcohol consumption, urinary tract infection, lack of fruits and vegetables during pregnancy were risk factors of hypertensive disorder of pregnancy. The governments and stakeholders should work to strengthen the antenatal care practice to include the possible risk factors of hypertensive disorders of pregnancy.

Frequency of pre-eclampsia in patients with abnormal uterine artery Doppler at twenty two to twenty four weeks of gestation.

Objectives: To determine the frequency of pre-eclampsia among pregnant ladies with abnormal uterine artery Doppler at 22- 24 weeks of gestation at a tertiary care hospital. Study Design: Cross sectional study. Setting: Department of Obstetrics and Gynecology, Nishtar Medical University / Hospital Multan. Period: All the women (n=160) with abnormal uterine artery from 01-07-2018 to 30-06-2019 were included. Material &amp; Methods: The pulsatility index (PI) of uterine artery Doppler was taken by taking average of 3 consecutive waveforms to determine the abnormal uterine artery Doppler. These study cases were followed till delivery to document pre-eclampsia. Results: Of these 160 study cases, 89 (55.6 %) had gestational age up to 23 weeks while 71 (44.4 %) had gestational age more than 23 weeks having mean age of 25.44 ± 4.77 years. Of these 160 pregnant ladies with abnormal uterine artery Doppler, 72 (45.0 %) were resident of rural areas and 88 (55.0 %) were resident of urban areas and family history of pre-eclampsia was 42 (26.3%). Previous history of pre-eclampsia was noted in 41 (25.6%). Mean parity was 2.24 ± 1.06 and 113 (70.6%) had parity up to 3. Mean gravidity of our study cases was 3.87 ± 1.16 and 89 (55.6%) had gravidity up to 4. Obesity was present in 30 (18.8 %) having mean body mass index 25.23 ± 1.92 kg/m2. Mean interpregnancy interval was 14.19 ± 6.82 months and 83 (51.9 %) had interpregnancy interval more than 1 year and pre-eclampsia was noted in 125 (78.1%). Conclusion: Very high frequency of pre-eclampsia was noted in our study in pregnant women presenting with abnormal uterine artery Doppler at 22 – 24 weeks of gestation. Pre-eclampsia was significantly associated with age, family history of pre-eclampsia, previous history of pre-eclampsia and interpregnancy interval.

Hubungan Kecemasan dan Kejadian Pre Eklamsia di RSUD dr. R. Goeteng Tarunadibrata Purbalingga

The conditions of pregnancy can increase anxiety in women, therefore it can cause a negativeimpact on pregnant women themselves and on their fetuses. Anxiety is one of the risk factors ofthe incidence of pre-eclampsia in pregnant women. Pre-eclampsia is still the top three causes ofmaternal death in the field of obstetrics in Indonesia. The purpose of this study is to know andanalyze the relationship of anxiety with the incidence of pre-eclampsia in RSUD Dr. R. GoetengTarunadibrata Purbalingga. This research is a quantitative study, with case control design,sampling technique with an accidental sampling approach. Data collection using a standardquestionnaire from Hamilton. Analysis in quantitative studies using the X2 test (chi square) Theresults of this study that there is no statistical relationship between anxiety and the incidence ofpre-eclampsia with a value of ρ = 0.732 but clinically found that mothers with anxiety have a riskof 1, 26 times higher experience pre-eclampsia ( value of OR = 1.26). As for some externalvariables in this study that theoretically become a predisposing factor for pre-eclampsia includingage, previous history of pre-eclampsia or hypertension, hereditary history, history of hormonalfamily planning acceptors related to pre-eclampsia.

Risk factors for hypertensive disorders of pregnancy in Abuja, Nigeria: A prospective case-control study

Background: Hypertensive disorders of pregnancy (HDP) are an important cause of maternal and perinatal morbidity and mortality throughout the world, particularly in developing countries like Nigeria. The study determined the risk factors for the development of HDP among women who booked early for antenatal care.Materials and Methods: This was a prospective case-control study conducted from March 2015 to March 2016 involving pregnant women with gestational age less than 20 weeks at booking and were followed up until delivery and 6 weeks postpartum. Information on gestational age at recruitment, at diagnosis of HDP, mode of delivery, and fetal outcome were recorded. Risk factors for HDP were compared between women who developed HDP (cases) and those who did not develop HDP (controls) by Fisher's exact test, Chi-square, and student's t-tests. Univariate and multivariate logistic regression analysis was used to test the relationship between certain risk factors and the development of HDP. A P value of less than 0.05 was considered statistically significant.Results: The prevalence of HDP in the study was 19.4%. Family history of preeclampsia (OR: 5.339, 95% CI: 1.149–24.818, P = 0.033); previous history of preeclampsia (OR: 10.819, 95% CI: 3.570–32.792, P < 0.001); multifetal gestation (OR: 13.275, 95% CI: 2.899–38.127, P = 0.010); chronic hypertension (OR: 3.431, 95% CI: 1.778–8.710, P < 0.001) and diabetes; (OR: 2.846 95% CI: 0.460–17.584, P < 0.251) were the risk factors associated with the development of HDP among the study population while nulliparity (OR: 0.726, 95% CI 0.366–1.440, P = 0.395); body mass index (BMI) (mean ± SD), (OR: 0.405, 95% CI: 0.173–0.945, P < 0.037);and low educational level (OR: 0.582, 95% CI: 0.070–4.857, P = 0.613) were not.Conclusion: The prevalence of HDP in the study group was high. Risk factors for HDP included family history of hypertension, previous history of preeclampsia, multifetal gestation, and chronic hypertension.

Vitamin D Status and the Determinants of Preeclampsia in Pregnant Women in Goma (Democratic Republic of the Congo)

Background: Preeclampsia (PE) is a common condition, causing maternal and perinatal morbidity and mortality worldwide. In the absence of fully satisfactory treatment, screening remains one of the pillars of management. Low vitamin D status has been identified as a risk factor for PE. But, data on vitamin D status and risk factors for PE in the Democratic Republic of the Congo (DRC) is scanty. The aim of this study is to determine the level of Vitamin D and risk factors in preeclamptic patients in our environment. Methods: To fill this gap, we conducted a multicenter incident case control study on 190 pregnant women, 95 cases and 95 controls, receiving care from seven hospitals in Goma, in the eastern DRC, from April 1 to December 31, 2019. Socioeconomic, diet habits, clinical data, urinalysis and serum 25-hydroxy vitamin D [25(OH)D] levels were analyzed. Vitamin D deficiency was defined as serum 25(OH)D < 30 ng/ml. Bivariate and multivariate analysis were used to assess risk factors of PE. Results: The median vitamin D level in preeclamptic women was lower than in the control group (21.7 [Interquartile Range (IQR) = 19.2 - 24.1] ng/ml versus 28.5 [IQR = 24.9 - 31.4] ng/ml; (p < 0.001). PE was associated with: 1) vitamin D deficiency, Odds Ratio (OR) = 2.77 at 95% Confidence Interval-CI of [1.22 - 6.31]; p = 0.015; 2) previous history of PE (OR = 12.30; 95% CI [1.92 - 18.98]; p = 0.008) and 3) high BMI (OR = 2.82; 95% CI [1.28 - 6.21]; p = 0.010). Smoking (OR = 0.33; 95% CI [0.22 - 0.98]; p = 0.015) and consumption of dairy products (OR = 0.39; 95% CI [0.17 - 0.92]; p = 0.032) were protective. Conclusion: The odds of PE were 3-fold in pregnant women with vitamin D deficiency. Vitamin D supplementation during pregnancy might reduce the risk of developing PE and ultimately reduce the consequences on maternal and perinatal advert outcomes.

The characteristics of preeclampsia among patients delivered through caesarean section at Sanglah General Hospital, Denpasar, Bali in 2018

Background: Preeclampsia is an exclusive disorder in pregnancy characterised by hypertension as well as proteinuria and is the primary cause of mortality and morbidity of pregnant women. This study aims to determine the characteristics or risk factors in preeclampsia patients who delivered through caesarean section within the period of January 1st to December 31st 2018 in Sanglah General Hospital Denpasar.Methods: This study used a retrospective descriptive study design by using 34 samples of preeclampsia patients in 2018 who underwent caesarean delivery in Sanglah General Hospital Denpasar. The characteristics of these pregnant women are categorized into their age, education level, Body Mass Index (BMI), ethnicity, occupation, education level, previous history of preeclampsia, family history of preeclampsia, existing chronic hypertension, parity, number of fetus in womb, frequency of Antenatal Care (ANC), and registration method. Data were analysed by SPSS version 17 for windows.Results: The preeclampsia sufferers were dominated by the age group of 20-35 years as many as 27 people (79.4%). The highest body mass index is in the 1 obese group of 10 people (29.4%). The majority of respondents were from Bali (61.8%). Working women were predominant (67.6 %), followed by SMA education level (14.7%), existing chronic hypertension (5.9%), nulliparous (41.1%), single fetuses (94.1%), and total frequency of ANC to midwife/obstetrician consisting about 61.8%.Conclusion: It can be concluded that the majority of the patients were in the age range of 20-35 years, were Balinese and had a BMI range of Obese I. Moreover, most the preeclampsia patients in this study were working women and had an education level mostly in SMA