Hypertensive disorder of pregnancy and its immediate outcome on neonates in a tertiary care hospital of Western Nepal

Authors

  • Badri Kumar Gupta Department of Pediatric, Universal College of Medical Sciences, Bhairahawa, Rupandehi, Nepal
  • Amit Kumar Shrivastava Department of Pharmacology, Universal College of Medical Sciences, Bhairahawa, Rupandehi, Nepal
  • Laxmi Shrestha Department of Pharmacology, Universal College of Medical Sciences, Bhairahawa, Rupandehi, Nepal

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20192200

Keywords:

Anti-hypertensive drugs, Gestational hypertension, Hypoxia, Hypertension, Maternal hypertension disorder of pregnancy, Preeclampsia

Abstract

Background: Hypertensive disorders in pregnancy remain a major cause of maternal and neonatal morbidity and mortality worldwide. This study prospectively examined the immediate neonatal outcome of women with maternal hypertensive disorder of pregnancy (HPD).

Methods: This is a prospective study conducted at NICU in Universal College of Medical Sciences Hospital over a period from 2nd February 2018 to 1st February 2019. Fifty-two mothers and their newborn were selected. Mothers with gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension and chronic hypertension were included.

Results: Mean maternal age was 26.4 years. Mean gestational age was 34±4 weeks. 38 were male and 24 were female with male: female ratio 1.72:1. Thirty seven (71.2%) mothers needed lower uterine caesarian section, fourteen (26.9%) mothers delivered NVD and one (1.9%) forceps delivery. Low birth weight (<2.5kg) babies were 25 (48.1%%), very low birth weight (<1.5kg) were 9 (17.3%) and normal weight were 18 (34.3%). Intrauterine growth retardation (IUGR) were 18(30%). Perinatal asphyxia 10 (19.2%) were most common cause of admission, other cause of admission were sepsis and prematurity.

Conclusions: Eclampsia is still a common and serious complication of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high risk patient, administered of MgSO4 in correct doses and properly timed caesarean section in selected cases would reduce the incidence of eclampsia associated maternal and perinatal morbidity and mortality in our facility.

References

Shah A, Fawole B, M'Imunya JM, Amokrane F, Nafiou I, Wolomby JJ, et al. Cesarean delivery outcomes from the WHO global survey on maternal and perinatal health in Africa. Inter J Gynecol Obst. 2009;107(3):191-7.

McClure EM, Saleem S, Pasha O, Goldenberg RL. Stillbirth in developing countries: a review of causes, risk factors and prevention strategies. J Maternal-Fetal Neonatal Med. 2009;22(3):183-90.

Prakash J, Pandey LK, Singh AK, Kar B. Hypertension in pregnancy: hospital based study. J Assoc Physicians India. 2006;54:273-8.

Hutter D, Jaeggi E. Causes and mechanisms of intrauterine hypoxia and its impact on the fetal cardiovascular system: a review. Inter J Pediatr. 2010 Oct 19;2010.

Backes CH, Markham K, Moorehead P, Cordero L, Nankervis CA, Giannone PJ. Maternal preeclampsia and neonatal outcomes. J Pregnancy. 2011;2011:1-7.

Hofmyr GJ, Belfort M. proteinuria as a predictor of complication of pre-eclemsia. BMC Medline. 2009;7:11.

Vest AR, Cho LS. Hypertension in pregnancy. Curr Atheroscler Rep. 2014;16:395.

American College of Obstetricians and Gynecologists. Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122:1122-31.

Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 2016 Apr 19;353:i1753.

Pijnenborg R, Vercruysse L, Hanssens M. The uterine spiral arteries in human pregnancy: facts and controversies. Placenta. 2006;27:939-58.

Smith SD, Dunk CE, Aplin JD, Harris LK, Jones RL. Evidence for immune cell involvement in decidual spiral arteriole remodeling in early human pregnancy. American J Pathol. 2009 May 1;174(5):1959-71.

Palei AC, Spradley FT, Warrington JP, George EM, Granger JP. Pathophysiology of hypertension in pre‐eclampsia: a lesson in integrative physiology. Acta Physiologica. 2013 Jul;208(3):224-33.

Gifford RW. Report of the national high blood pressure education program working group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183:S1-5.

Datta’s DC. Hypertensive disorder of pregnancy. Hirala Kona. Editor. Textbook of obstetrics. 17th Ed. New central Book Agency Limited; 2011;219-220.

Roberts CL, Algert CS, Morris JM, Ford JB, Henderson-Smart DJ. Hypertensive disorders in pregnancy: a population based study. MJA. 2005;182:332-5.

Tranquilli AL, Giannubilo SR. The weight of foetal growth restriction in 437 hypertensive pregnancies. Arch Gynecol Obstet. 2004;270:214-6.

Dudell GG, Jain L. Hypoxic respiratory failure in the late preterm infant. Clinics Perinatol. 2006 Dec 1;33(4):803-30.

Markestad T, Vik T, Ahlsten G, Gebre-Medhin M, Skjærven R, Jacobsen G, et al. Small-for-gestational-age (SGA) infants born at term: growth and development during the first year of life. Acta obstetricia et gynecologica Scandinavica. Supplement. 1997;165:93-101.

Deorari AK, Arora NK, Paul VK, Singh M. Perinatal outcome in hypertensive disease of pregnancy. Indian Pediatr. 1985;22:877-81.

Joshi N, Pandit SN, Shah PK, Vaidya PR. A study of pre-eclampsia to xemia in pregnancy. Indian J Obstet Gynecol. 1990;40:506-9.

Sibai BM. Antihypertensive drugs during pregnancy. Semin Perinatol. 2001;25:159-64.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. Hypertension. 2003;42:1206-52.

Levine RJ, Lam C, Qian C, Yu KF, Maynard SE, Sachs BP, et al. Urinary placental growth factor and risk of preeclampsia. JAMA. 2005;293:77-85.

Roberts CL, Algert CS, Morris JM, Ford JB, Henderson-Smart DJ. Hypertensive disorders in pregnancy: a population-based study. MJA. 2005;182:332-5.

Goften EN, Capewe lV, Natale R, Gratton RJ. Obstetric al intervention rates and maternal and neonatal outcomes of women with gestational hypertension. Am J Obstet Gynecol. 2001;185:798-803.

Habli M, Levine RJ, Qian C, Sibai B. Neonatal outcomes in pregnancies with preeclampsia or gestational hypertension and in normotensive pregnancies that delivered at 35, 36, or 37 weeks of gestation. American J Obstetrics Gynecol. 2007 Oct 1;197(4):406-e1.

Saftlas AF, Olson DR, Franks AL, Atrash HK, Pokras R. Epidemiology of preeclampsia and eclampsia in the United States, 1979-1986. Ame J Obstetrics Gynecol. 1990 Aug 1;163(2):460-5.

Aucott SW, Donohue PK, Northington FJ. Increased morbidity in severe early intrauterine growth restriction. J Perinatol. 2004 Jul;24(7):435.

Richardus JH, Graafmans WC, Verloove‐Vanhorick SP, Mackenbach JP. Differences in perinatal mortality and suboptimal care between 10 European regions: results of an international audit. BJOG: An Inter J Obst Gynaecol. 2003 Feb 1;110(2):97-105.

Ray JG, Burrows RF, Burrows EA, Vermeulen MJ. Outcome study of hypertension in pregnancy. Early Hum Dev. 2001;64:129-43.

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785-99.

Yadav S, Saxena U, Yadav R, Gupta S. Hypertensive disorders of pregnancy and maternal and fetal outcome: A case controlled study. J Indian Med Assoc. 1997;95:548-6551.

Sibai BM. Eclampsia: VI. Maternal perinatal outcome in 254 consecutive cases. Am J Obstet Gyneocol. 1990;163:1054-5.

Schiff E, Friedman SA, Mercer BM, Sibbai BM. Fetal lung maturity is not accelerated in pre eclamptic pregnancies. Am J Obstet Gynecol. 1993;169:1096-101.

Silveira RC, Procianoy RS, Koch AS, Benjamin AC, Schindwein AF. Growth and neuro development outcome of very low birth weight infants delivered by preeclamptic mothers. Acta Paediatr. 2007;96:1738-42.

Bashiri A, Zmora E, Sheiner E, Hershkovitz R, Shoham-VardiI, Mazor M. Maternal hypertensive disorders are an independent risk factor for the development of necrotizing enterocolitis in very low birth weight infants. Fetal Diagn Ther. 2003;18:404-7.

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Published

2019-05-23

How to Cite

Gupta, B. K., Shrivastava, A. K., & Shrestha, L. (2019). Hypertensive disorder of pregnancy and its immediate outcome on neonates in a tertiary care hospital of Western Nepal. International Journal of Basic & Clinical Pharmacology, 8(6), 1343–1348. https://doi.org/10.18203/2319-2003.ijbcp20192200

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Original Research Articles