Adverse perinatal outcomes in pregnancies complicated with placental abruption accompanied by hypertensive disorders of pregnancy

AIM:To compare cerebroplacental and cerebrouterine ratio as predictors of perinatal outcome in hypertensive disorders of pregnancy. METHODS: A prospective cohort study was done at a tertiary hospital in Northern India. Singleton pregnancies of gestational age >28 weeks, having BP>140/90mm of Hg with/without proteinuria >30mg/dL(+1 dipstick)were included. Doppler indices were measured, and perinatal outcomes studied. RESULTS:Cerebrouterine(CU) and cerebroplacental(CP) ratios had a better negative predictive value for adverse perinatal outcomes(except Apgar and preterm birth). CP ratio had highest sensitivity and specicity for outcomes perinatal death (100% and 95.9%), ventilatory support (100% and 97.2%) and hypoglycemia (100% and 95.9%). CU ratio had maximum sensitivity and specicity for the outcome hypoglycemia (100% and 95.9%). CONCLUSIONS:CP ratiohas a higher efcacy than CU ratio, however CU ratio compliments its predictive ability. Higher negative predictive values indicate that these ratios correctly ruled out unfavourable perinatal outcomes. Further studies to derive more sensitive values of CU ratio with normotensive patients and a larger sample size would be benecial.

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Perinatal outcomes of women with hypertensive disorders of pregnancy in Jimma Medical Center, southwest Ethiopia: Retrospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0256520 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256520

Author(s):

Debela Dereje Jaleta ◽

Tadesse Gebremedhin ◽

Mulusew Gerbaba Jebena

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Medical Center ◽

Perinatal Outcomes ◽

Hypertensive Disorder ◽

Hypertensive Disorders Of Pregnancy ◽

Southwest Ethiopia ◽

Hypertensive Disorders ◽

Adverse Perinatal Outcomes

Background Hypertensive disorders of pregnancy (HDP) increases adverse perinatal outcomes in women with the disorder. About 16% of all still births and 10% of early neonatal deaths are accounted by HDP. In Ethiopia, HDP complicates about 6% of all pregnancies. Hence, the objective of this study was to determine the risk of adverse perinatal outcomes among women with HDP in Jimma Medical Center, southwest Ethiopia. Methods A retrospective cohort study was conducted on a total of 777 women who gave birth from June 2017 to March 2020 at Jimma Medical Center, southwest Ethiopia. Women with HDP and normotensive women who gave birth at or after 28 weeks of gestation were enrolled as exposed and unexposed respectively. Simple random sampling technique was used to select study participants. Data were reviewed using structured data collection performa that was prepared after reviewing relevant literatures. Data were entered to Epi-Data then exported to STATA version 13 for analysis. The adverse perinatal outcomes risk were examined using log binomial and modified Poisson regression model with robust standard errors. Results In this study, the overall incidence of adverse perinatal outcome was higher among women with hypertensive disorders of pregnancy (HDP) than normotensive women (64.1% versus 32.8%). After adjusting for confounders, women with HDP were at higher risk of babies with low birth weight (adjusted RR = 2.88 (2.2, 3.75)), preterm birth(aRR = 2.31(1.7, 3.14)), fifth minute low Apgar score (aRR = 2.6(1.53, 4.42)), admission to neonatal intensive care unit (aRR = 1.77(1.32, 2.37), stillbirth (aRR = 2.02(1.11, 3.01)), and perinatal mortality (aRR = 3.88(1.97, 7.66)) than normotensive women. Conclusion Women with hypertensive disorder of pregnancy were at higher risk of adverse perinatal outcomes than normotensive women who gave birth at Jimma Medical Center, southwest Ethiopia. Therefore, health care providers should strengthen prevention, early diagnosis and prompt management of HDP in order to reduce adverse perinatal outcomes.

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Associations of maternal vitamin D, PTH and calcium with hypertensive disorders of pregnancy and associated adverse perinatal outcomes: Findings from the Born in Bradford cohort study

Scientific Reports ◽

10.1038/s41598-018-37600-9 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 6

Author(s):

Gillian Santorelli ◽

Donald Whitelaw ◽

Diane Farrar ◽

Jane West ◽

Debbie A. Lawlor

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Perinatal Outcomes ◽

Hypertensive Disorders Of Pregnancy ◽

Maternal Vitamin ◽

Hypertensive Disorders ◽

Born In Bradford ◽

Adverse Perinatal Outcomes

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Can serum homocysteine predict hypertensive disorders of pregnancy?: an evidence from a case control study in a North Indian tertiary health care institution

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193521 ◽

2019 ◽

Vol 8 (8) ◽

pp. 3117

Author(s):

Kushla Pathania ◽

S. K. Verma ◽

Shaina Chamotra ◽

Ankit Chaudhary

Keyword(s):

Case Control Study ◽

Homocysteine Level ◽

Perinatal Outcomes ◽

Case Control ◽

Unknown Etiology ◽

Intrauterine Death ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Increased Risk ◽

Control Study

Background: Hypertensive disorders of pregnancy are a major cause of both maternal and foetal morbidity and mortality. Although pregnancy induced hypertension (PIH) is still regarded as a disease of theories and unknown etiology, elevated homocysteine level has been hypothesized as a key risk factor. Abnormally raised homocysteine has been significantly associated with increased risk of PIH, abruption, intrauterine growth restriction, recurrent pregnancy loss, intrauterine death and prematurity.Methods: The present case control study was conducted among 180 pregnant women (90 cases and 90 controls) in Kamla Nehru State Hospital for Mother and Child, IGMC Shimla, Himachal Pradesh with an objective of ascertaining the role of homocysteine in pregnancy related hypertensive disorders. Socio-demographic, clinical, biochemical including homocysteine level, laboratory and ultrasonographic parameters of all the participants were documented.Results: The mean homocysteine level of cases (18.30±10.81) was significantly higher than the controls (8.70±2.64). About 62.2% cases had abnormally raised homocysteine level (>15 µmol/L), while only 1.1% controls had such level. The odds of a case having abnormally elevated homocysteine level were 146.6 (CI: 19.52-1101) times to that of controls. Eclamptics had the highest homocysteine level followed by preeclamptics and controls.Conclusions: The present study significantly associates the abnormally elevated homocysteine levels with pregnancy related hypertensive ailments and demands much needed robustly designed studies to further explore the phenomenon. A simple intervention like estimating the much neglected homocysteine levels prior to pregnancy can definitely aid in predicting and preventing perinatal outcomes.

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The 2011 Survey on Hypertensive Disorders of Pregnancy (HDP) in China: Prevalence, Risk Factors, Complications, Pregnancy and Perinatal Outcomes

PLoS ONE ◽

10.1371/journal.pone.0100180 ◽

2014 ◽

Vol 9 (6) ◽

pp. e100180 ◽

Cited By ~ 65

Author(s):

Chun Ye ◽

Yan Ruan ◽

Liying Zou ◽

Guanghui Li ◽

Changdong Li ◽

...

Keyword(s):

Risk Factors ◽

Perinatal Outcomes ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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Perinatal Outcomes Associated with Maternal Hypertensive Disorders of Pregnancy in a Developing Country

Hypertension in Pregnancy ◽

10.3109/10641955.2010.525280 ◽

2011 ◽

Vol 31 (1) ◽

pp. 120-130 ◽

Cited By ~ 16

Author(s):

Bolajoko O. Olusanya ◽

Olumuyiwa A. Solanke

Keyword(s):

Developing Country ◽

Perinatal Outcomes ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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Migraine-Asthma Comorbidity and Risk of Hypertensive Disorders of Pregnancy

Journal of Pregnancy ◽

10.1155/2012/858097 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 10

Author(s):

Stefanie Czerwinski ◽

Jolana Gollero ◽

Chunfang Qiu ◽

Tanya K. Sorensen ◽

Michelle A. Williams

Keyword(s):

Medical Records ◽

Symptom Management ◽

Perinatal Outcomes ◽

Reproductive Age ◽

Pregnancy Induced Hypertension ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Reproductive Age Women ◽

Asthma Status ◽

Induced Hypertension

Background. To evaluate the association of migraine and asthma and to estimate the risk of hypertensive disorders of pregnancy in relation to maternal comorbid migraine and asthma.Methods. Reproductive age women (N=3.731) were interviewed during early pregnancy. At the time of interview, we ascertained participants’ migraine and asthma status. From medical records, we collected information to allow the diagnosis of pregnancy-induced hypertension (PIH) and preeclampsia. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression procedures.Results. After adjusting for confounders, migraineurs had 1.38-fold increased odds of asthma as compared with nonmigraineurs (95% CI 1.09–1.38). The odds of hypertensive disorders of pregnancy were highest among women with comorbid migraine-asthma. The ORs for PIH preeclampsia and the two disorders combined were 2.53 (95% CI 1.39–4.61), 3.53 (95% CI 1.51–8.24), and 2.64 (95% CI 1.56–4.47), respectively, for women with comorbid migraine-asthma as compared with those who had neither disorder.Conclusion. These findings confirm prior reports and extend the literature by documenting particularly high odds of pregnancy-induced hypertension and preeclampsia among women with comorbid migraine-asthma. Increased knowledge about the prevalence and sequelae of comorbidities during pregnancy may lead to improved symptom management and perinatal outcomes.

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