European Journal of Molecular & Clinical Medicine

Background: To assess early neonatal outcome in low- birth weight babies in hypertensive disorders complicating pregnancies with the mode of delivery.
Materials and Methods: Eighty- women delivering low birth weight babies with hypertension complicating pregnancies were divided into 2 groups of 40 each. Group I was vaginal delivery group and group II was caesarean delivery group. Parameters such as types of hypertensive disorders in pregnancies, early neonatal outcome and neonatal complications were recorded.
Results: There were 18 patients in group I and 20 in group II with preeclampsia, 6 in group I and 7 in group II eclampsia, 12 in group I and 11 in group II gestational hypertension and 4 in group I and 2 in group II chronic hypertension with superimposed preeclampsia. The difference was non- significant (P> 0.05). Age group 21-25 years had 26 patient sin group I and 25 in group II. There were 28 Primigravida in group I and 24 in group II and 12 multigravida in group I and 16 in group II. SES was lower in 27 in group I and 22 in group II, middle in 10 in group I and 13 in group II and upper in 3 in group I and 5 in group II. The difference was significant (P<0.05) (Table II). APGAR at 1 minute (4-6) was seen in 28 and 26, APGAR at 5 minutes (7-10) was seen in 21 and 25, NICU admission was present in 27 and 31 and NICU admission was absent in 13    and 9 in group I and II respectively. The difference was significant (P<0.05). Neonatal complications observed were RDS        in 15% and 21%, birth asphyxia in 12% and 6%, intraventricular haemorrhage (IVH) in 7% and 3%, meconium aspiration syndrome (MAS) in 6% and 3% and sepsis in 7% and 5% in group I and II respectively. The difference was significant (P<0.05).
Conclusion: Neonatal outcomes are not worsened by spontaneous or induced vaginal delivery in women with hypertension with good control and also decreases morbidity due to caesarean section to the mother. Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for LBW vertex presenting foetuses in PIH patients.

The hypertensive disorders of pregnancy are among the leading causes of maternal and fetal morbidity and mortality. This study was conducted to assess early neonatal outcome in low- birth weight babies in mothers with hypertensive disorders.
Materials &Methods: 70 women with hypertension delivering low birth weight babies were divided into 2 groups of 35 each. Group I was vaginal delivery group and group II was caesarean delivery group. Parameters such as types of hypertensive disorders in pregnancies, early neonatal outcome and neonatal complications were recorded.
Results: Pre-eclampsia was seen in 12 in group I and 14 in group II, eclampsia 8 in group I and 7 in group II, gestational hypertension 10 in group I and 8 in group II and chronic hypertension with superimposed preeclampsia 5 in group I and 6 in group II. The difference was non- significant (P> 0.05).APGAR at 1 minute (4-6) was seen in 20 and 22, APGAR at 5 minutes (7-10) was seen in 15 and 13, neonates & groups I&II NICU admission was present in 26 and 24 and NICU admission was absent in 9 and 11 in neonates in group I and II respectively. Neonatal complications observed were RDS in 3 and 5, birth asphyxia in 6 and 3, intraventricular haemorrhage (IVH) in 3 and in group I and II respectively. The difference was significant (P<0.05).
Conclusion: Caesarean delivery offers no short-term survival advantage compared with vaginal delivery for low- birth weight vertex in PIH patients.

Background: In India there is a decline in MMR compared to 2010 statistics. Severe Acute Maternal Morbidity (SAMM) has been introduced to analyze the quality of the health care system, thus to improve the obstetric care. SAMM and Near Miss events are complimentary to MMR. This concept was defined by the World Health Organization (WHO) as “a woman who, being close to death, survives a complication that occurred during pregnancy, delivery or up to 42 days after the end of her pregnancy”.
Aim: To estimate the magnitude, associated Morbidity, various interventions and maternal and perinatal outcome for near miss cases (MNM) at tertiary care center.
Method: The prospective observational study was conducted in a Government medical college and hospital, Aurangabad from 2018 to 2020 after Institution Ethics Committee approval. Data of 350 near miss cases were analysed and also categorized based on adverse event identified in 1) Pregnancy Specific Obstetric and Medical disorder 2) Pre-Existing disorders aggravated during pregnancy 3) Accidental/Incidental disorders of pregnancy.
Results: The magnitude of near miss cases (MNM) was found to be 1.10 per 1000 live birth and maternal mortality (MMR) observed was 0.41 per 1000 live birth. Maternal near miss to maternal death ratio was 2.71:1. In present study anaemia (65.43%) and PIH (64.29%) was associated risk factors of maternal near miss. Further it was seen that the causes of MNM was Atonic PPH in 64% of cases followed by severe preeclampsia in 54% of cases.
Conclusion: It can be concluded from this study that hemorrhage during pregnancy are the most common cause maternal morbidity in the study group, followed by ruptured ectopic pregnancy. Hence, services at the grass route level helps in early identification, treatment and proper referral of complicated pregnancies should be made available. Proper insemination IEC activities of the primary health care staff about the complication among the antenatal mothers, their referral and further evaluation of the disorder should be given.

Background:Hypertension is a prevalent and serious disorder that can cause or
exacerbate many health issues. Blood pressure is directly associated to cardiovascular
disease and mortality. Stroke, MI, angina, heart failure, renal failure, and
cardiovascular mortality are all linked to BP. As a result, hypertension is often referred
to as "the silent killer." The study's aim is to assess maternal morbidity and mortality
in pregnant women with pregnancy-induced hypertension. Birth weight, Apgar score,
NICU admission, prenatal morbidity and mortality.
Materials and Methods: During two years, pregnant women aged 21 to 40 weeks were
studied at Govt Medical College &Hospital Nalgonda (July 2019-July 2021). An 80-
patient study. The institutional ethics committee review board approved. Each patient
had a comprehensive history, clinical examination, and proforma. In all instances, the
length of hospital stay, patient recovery, perinatal outcome (birth weight, Apgar score,
NICU admission), and perinatal morbidity and mortality were examined.
Results: he present investigation found that unbooked cases had more severe
preclampsia and eclampsia. Preeclampsia patients who had not had routine prenatal
care were 40 percent unbooked. Unbooked cases have increased maternal and perinatal
mortality. In this study, 40% of NICU admissions were due to LBW/asphyxia. Overall,
50% of newborns were born underweight. PIH was a prominent cause of iatrogenic
premature birth.
Conclusion: 100% registration of pregnant women and good quality antenatal
treatment including weight, blood pressure, and urine analysis with adequate referral
mechanism to tertiary care centres.All family physicians and medical officers need to be
advised to follow a standard management protocol in a case of preeclampsia and
eclampsia with an awareness for prompt referral of women who require to be managed
by specialist. Every tertiary care centre must have specialised expertise. Though PIH is
not preventable, adequate ANC care can slow its progression and timely intervention
can significantly improve perinatal outcomes.

Aim: To compare serum calcium status in pregnant women with and without PIH.
Material and method:It was a hospital based prospective observational study conducted
in the department of Obstetric and Gynecology, National Capital Region Institute of
Medical Sciences, Meerut for a period of 12 months. 200 antenatal cases after 20 weeks
pregnancy having age between 18-40 years were divided into 2 types based on BP i.e.
Cases-100 patients of PIH (Pregnancy induced hypertension) and Control- 100
normotensive patients. A detailed family and medical history of all the childbearing
women with gestational age 20 weeks or more admitted with the features of HDP
(hypertension disorder of pregnancy) was recorded followed by a thorough clinical
examination. Systolic and diastolic blood pressure of all the participants was carefully
recorded every four hourly. Serum calcium levels were measured by the O- Cresol
PhthaleinComplexone (OCPC) method.
Results: Mean SBP in case and control group was 152.30±10.45 and 118.20±7.66
respectively. Mean DBP in case and control group was 99.42±7.29 and 75.82±5.21
respectively. Hence SBP and DBP was higher in case group as compared to control
group. According to Pearson correlation analysis, negative significant correlation was
found between BP and serum calcium(mg/dL) i.e. with increase in BP, there is decrease
in serum calcium(mg/dL).
Conclusion:The present study emphasizes the need of monitoring serumcalcium during
antenatal period and appropriatemeasures may reduce the incidence of PIH.In areas
where dietary calcium intake is low,calcium supplementation during pregnancy (atdoses
of 1.5–2.0 g elemental calcium/day) isrecommended for the prevention of PIH in all
women, but especially those athigh risk of developing PIH.