Online ISSN: 2515-8260

Keywords : gestational hypertension


A clinical study of maternal and neonatal outcome in pregnant women with obesity (BMI more than 30) at a tertiary hospital

Dr. Anurag Sonawane, Dr. Shrinivas Gadappa, Dr. Sandeep S Mannikatti, Dr. Rupali A Gaikwad .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1123-1129

Background: Obesity is one such pre-existing maternal morbidity that puts a pregnancy at risk. Maternal obesity is a frequent high-risk factor with substantial prenatal, intranasally, and postnatal problems. This study aimed to analyze maternal and fetal outcome in obese pregnant women (BMI more than 30) at our tertiary care teaching hospital.
Material and Methods: This study was prospective & observational study, conducted in pregnant women, gestational age > 28 weeks, with BMI > 30, delivering at our labour room. Maternal and neonatal outcomes were analysed.
Results: Among 453 pregnant women with BMI > 30kg/m2, majority were from 19—25 years age group (45.1 %), 48.03% were primigravida, 82.33% had > 37 weeks of gestation. In the study group 78.43% were moderately obese, 15.69% were severely obese and only 5.88% were morbidly obese. Most common pre pregnancy medical disorder in obese women were preeclampsia (21.57 %), previous LSCS (20.59 %), severe anaemia (19.54 %), gestational diabetes mellitus (12.75 %), gestational hypertension (9.80 %) & multiple pregnancy (1.96 %). Common intrapartum events were Preterm labor (16.67 %), PPH (6.78 %), Abruptio placenta (4.90 %), Mal presentation Breech (4.90%) & Eclampsia(1.96%).63.71%of obese pregnant women delivered by normal vaginal delivery, 31.37% of obese pregnant women underwent cesaerian section & 4.90% of obese women were requiring instrumental delivery. Common indication for NICU admission were infant of diabetic mother (22.55 %), preterm (14.71 %), meconium aspiration (5.88 %), macrosomia (3.92 %), asphyxia (1.96 %) & transient tachypnia of new born (1.96%). No maternal or neonatal mortality observed in present study.
Conclusion: In obese pregnant women with BMI >30kg/m2, higher incidence of gestational hypertension, preeclampsia, gestational diabetes mellitus, anaemia, malpresentation, cephalopelvic disproportions and hypothyroidism isnoted,

A prospective study of coagulation profile in patients of pregnancy induced hypertension

Dr. Manoj Kumar, Dr. Ramesh Kumar Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11030-11035

Introduction: The most common disorders that are associated with pregnancy are
Eclampsia. Hypertensive disorders of pregnancy affect about 10% of all pregnant
women globally. The prevalence of Pregnancy Induced Hypertension in India ranges
from 5 - 8%. Hypertensive disorders of pregnancy are the frequent cause of severe
acute morbidity, long term disability and death among pregnant mothers and
babies.Abnormal coagulation of blood can be a cause of frequent haemorrhages in
women. There is a strong association between the two most important causes of
maternal mortality and morbidity globally such as Preeclampsia and Postpartum
haemorrhage. Recently, there is no observable screening test that would help in
identifying which pregnancy will be affected with PIH or assess its
severity.Hypertension prior to 20 weeks gestation is almost always is due to chronic
hypertension; preeclampsia is rare prior to the third trimester.5 Hence this study was
done to study the platelet and coagulation abnormalities occurring in patients of PIH
including platelet count, PT and APTT parameters.

Risk factors of perinatal mortality in a tertiary care centre: A case control study

Sunita S, Priyanka Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2653-2660

Background: Perinatal mortality has remained a major public health problem in India, this study aims to analyze the perinatal deaths and the risk factors attributed to perinatal mortality.
Methodology: This is a case-control study, we studied 72 cases and 72 controls. Cases were the patients admitted in labour room with gestational age >28 weeks who gave birth to stillborn or whose babies died within first 7 days of life and controls were ones who gave birth to live babies and whose babies survived more than 7 days of life. The analysis was done using appropriate epi info statistical package and regression analysis was done to quantify independent risk factors in perinatal mortality.
Results and Interpretation: Of the 72 cases, 55 cases had stillbirths contributing to 76.3% and the 17 cases had early neonatal deaths contributing to 23.7% of perinatal mortality. The mean maternal age for cases was 26.4 and for controls, it is 25.1. Controls had regular ANCs (75%) compared to cases (45.4%) with OR of 0.26(0.10-0.67). Cases that were referred to as IUDs contributed majorly for perinatal mortality. Early preterm births were more common among cases (58.3%) with OR 34.82(11.06-109.6) and P value <0.001. Gestational hypertension was the most common medical complication found among the cases (15.3%). 10 Anomalous babies were seen in cases. (48.6%) of cases had preterm delivery compared to controls with (8.3%) and rate of LSCS was high 7.3 times higher in cases compared to the control group. Low birth weight babies were 7.7 times more common among cases with P <0.001. Low APGAR at birth was more among cases compared to controls. Birth asphyxia was the commonest factor found in early neonatal deaths and 41.1% of babies died on day 1.
Conclusions: Lack of regular ANCs, late referrals of high-risk patients, complications like gestational hypertension, IUGR, prematurity, anomalies among babies, low birth weight, low APGAR score at birth, birth asphyxia were some of the factors found ascribed to perinatal mortality.

To evaluate the fundus changes in patients with hypertensive disorders of pregnancy: Gestational hypertension, preeclampsia, eclampsia

Dr. Tania Sadiq, Dr.Saima Sadiq, Dr.Erum Khateeb

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 67-73

Aim: To evaluate the fundus changes in patients withGestational
hypertension,preeclampsia oreclampsia.
Methods: All the patients who fulfilled the diagnostic criteria of Gestational
hypertension, preeclampsia or eclampsia(>20 weeks of pregnancy, high arterial blood
pressure of more than or equal to 140/90 , proteinuria more than or equal to
300mg/day or protein creatinine ratio more than or equal 30 mg/mmol or evidence of
maternal organ dysfunction or uteroplacental dysfunction , convulsions or coma) were
included in this study. After taking history for any eyesymptoms, anterior segment was
examined with torch light on the bed itself. Both pupils were dilated with 1%
tropicamide eye drops and fundus examination was done by ophthalmologist with direct
ophthalmoscope in a semi dark room in the ward. Hypertensive retinopathy changes
seen in right or left or both eyes, was taken as positive findings in that patient.
Results: A total of 100 patients were examined. The mean age of patients was 31.2±6.2
years (range 20-50 years). The gestation period ranged between 25 and 41 weeks. 45
(45%) were primigravidas , 33 (33%) were multigravidas and 22(22%) were
grandmultiparas. 41(41%) had mild preeclampsia, 56(56%) had severe preeclampsia
and 3(3%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in
58(58%) patients . There was statistically significant positive association between the
presence of retinal changes and blood pressure (P =0.001), proteinuria (P=0.021) and
severity of hypertensive disorders( P=0.027). However, age(P = 0.44), race ( P=0.89) and
gravida (P =0.37 were not associated with occurrence of retinopathy in our study.
Conclusion: Fundus examination in gestational hypertension , preeclampsia and
eclampsia is important in monitoring and managing cases as it correlates with severity
as it indirectly implies severity of changes in placental micro-circulation that can help to
predict the foetal outcome and ocular morbidity.

COMPARATIVE STUDY BETWEEN CARDIOTOCOGRAPH AND CEREBROPLACENTAL RATIO IN PREDICTING PERINATAL OUTCOME IN HYPERTENSIVE DISORDER OF PREGNANCY: AN ORIGINAL RESEARCH

Dr.Subhasri Mishra; Dr. Sujata Singh; Dr. Swayamsidha Mohanty; Dr. SusreeSovana Mishra

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 7308-7322

Introduction:Gestational hypertension, Preeclampsia, Eclampsia are pregnancy specific syndrome characterised by reduced organ perfusion secondary to vasospasm and endothelial pathology.Hypertensive state of pregnancy affect maternal and fetal circulation leading to prematurity, IUGR, Fetal demise.So it is a major cause of maternal and perinatal morbidity and mortality worldwide.Identification of pregnancy at risk for preventing perinatal morbidity
and mortality is a primary goal of obstetrics care.