scholarly journals Maternal and perinatal outcome in women with hypertensive disorders in pregnancy

2021 ◽  
Vol 10 (2) ◽  
pp. 46-49
Author(s):  
Lakshmi A ◽  
Akshatha DS ◽  
Pooja P ◽  
Prashanth FG ◽  
Veena MV ◽  
...  
Keyword(s):  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Fetal Mortality ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Mortality And Morbidity ◽  
Hypertensive Disorders ◽  
Study Results ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Aims and objectives To determine the effect of hypertension in pregnancy To determine the maternal and fetal outcome in patients with hypertensive disorders of pregnancy. Materials and methods This is a retrospective study conducted in ESIC MC and PGIMSR, Bangalore from January 2020 to December 2020. All pregnant women who presented with Hypertensive disorder in pregnancy were included in the study. Results A total of 1503 patients who delivered during the study period were included in the study of which 172 patients had hypertensive disorder (11.44 %). Gestational hypertension occurred in 113 cases, preeclampsia in 45 cases, chronic hypertension in 8 cases, chronic hypertension with superimposed preeclampsia in 2 cases and eclampsia in 4 cases. Of these 85(49.41%) cases were primigravida and 87(50.58%) were multigravida. 38 deliveries occurred preterm and 134 were term. 4 patients had intrauterine fetal demise. Gestational diabetes occurred in 30(17.44%) cases, hypothyroidism in 45 cases(26.16%), IUGR in 11 cases(6.39%), oligohydramnios in 10 cases(5.81%). Discussion Hypertensive disorders in pregnancy is a spectrum of disease. It is one of the non communicable diseases occurring in pregnancy. It is the third most common cause of maternal mortality. By timely detection and proper management, it is possible to decrease the complications and adverse outcomes associated with this condition. Conclusion Hypertensive disorders in pregnancy is an important cause for maternal and fetal mortality and morbidity. Hence it is important to identify the risk factors and prevent it for better outcome.

scholarly journals Kasus Hipertensi pada Kehamilan di Indonesia

2018 ◽  
Vol 32 (9) ◽  
pp. 295
Author(s):  
Novi Kartika Sari ◽  
Theodola Baning Rahayujati ◽  
Mohammad Hakimi
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Sampling Technique ◽  
Chronic Hypertension ◽  
Chi Square ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Cross Sectional Design ◽  
In Pregnancy

Determinants of pregnancy hypertensive disorders in Indonesia PurposeThis study aimed to assess the determinant factors of gestational hypertension (HDP) in Indonesia.MethodsThis research was an observational analytic study using a cross-sectional design. Sampling was calculated using consecutive sampling technique. The subjects were all pregnant women aged 15-54 years old in 33 provinces in Indonesia and 9024 women were selected as subjects. Chi-square and binomial regression tests were used to analyze the determinants of HDP to see the value of the Ratio Prevalence (RP). ResultsThe prevalence of hypertension among pregnant women was 6.18% (558 people) after being adjusted with external variables which were potentially confounders. The highest of hypertension was found in West Java with 59 pregnant women (10.57%). Overweight and chronic hypertension were related to hypertensive disorders in pregnancy with RP: 2.13 (95% CI: 1.80-2.51); and in overweight with RP: 4.36 (95% CI: 3.6-5.26) in hypertension assessments. The use of contraceptives was not a risk factor for hypertensive disorders in Indonesia with RP 0.92 (95% CI: 0.76-1.10). ConclusionOverweight and chronic hypertension are risk factors for the incidence of hypertensive disorders in pregnancy in Indonesia.

scholarly journals Hypertensive Disorders in Pregnancy

2018 ◽  
Vol 03 (02/03) ◽  
pp. 068-078
Author(s):  
Lalita Nemani
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Stress Test ◽  
Later Life ◽  
Chronic Hypertension ◽  
Prevention Measures ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Abstract Hypertension in pregnancy is defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg or both on two different occasions at least 6 hours apart. Severe hypertension is SBP ≥ 160 mm Hg or DBP ≥ 110 mm Hg. Hypertension is the most common medical problem in pregnancy and one of the major causes of maternal and perinatal mortality and morbidity. Hypertensive disorders in pregnancy (HDP) are classified as (1) chronic hypertension, (2) chronic hypertension with superimposed preeclampsia, (3) preeclampsia-eclampsia, and (4) gestational hypertension. HDP contributes to increased risk of hypertension, stroke, and maternal cardiovascular disease (CVD) in later life. HDP can be considered as a failed cardiovascular stress test identifying women susceptible to CVD in later life. Further research is required to identify the mechanisms in HDP that contribute to CVD in later life so as to initiate appropriate prevention measures.

scholarly journals Hypertension in pregnancy

2007 ◽  
Vol 1 (1) ◽  
pp. 13-20
Author(s):  
Andrea Ungar ◽  
Elena Lotti ◽  
Lorella Lambertucci
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Medical Problem ◽  
Chronic Hypertension ◽  
Intrauterine Growth ◽  
Relative Paucity ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Prompt Diagnosis ◽  
In Pregnancy

Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

scholarly journals Management of Hypertensive Disorders in Pregnancy- An Update

2013 ◽  
Vol 25 (1) ◽  
pp. 24-32
Author(s):  
K Nahar ◽  
TR Laila ◽  
N Akhter ◽  
PA Shamsunnahar ◽  
K Khatun ◽  
...  
Keyword(s):  
Gestational Hypertension ◽  
Expectant Management ◽  
Fetal Lung ◽  
Medical Problem ◽  
Hypertensive Disorder ◽  
Maternal Complications ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Obstetric Management ◽  
In Pregnancy

Hypertensive disorder is the most common medical problem encountered in pregnancy with a high perinatal and maternal mortality & morbidity. According to the onset of hypertension in relation to pregnancy and its duration and the development of proteinuria & convulsion it is   categorized into several types. The prognosis depends on duration and severity of hypertension and multi-system involvement. Aim of management is to achieve a gradual and sustained lowering of BP to prevent maternal complications and to allow prolongation of pregnancy for fetal benefit. For management purpose, according to recent NICE clinical guideline gestational hypertension has been classified into mild, moderate and severe hypertension. Till now there is controversy regarding the use of antihypertensives in mild to moderate hypertension. Labetalol, hydralazine & methyldopa are used as first line drugs according to severity of hypertension. Magnesium sulphate is the anticonvulsant of choice and nimodipine is the newer alternative. Obstetric management in all the types of hypertensive disorders is almost same .Expectant management can be considered for women at <34 weeks gestation only in well equipped   centers capable of caring very pre-term babies. Antenatal corticosteroid is recommended for enhancing fetal lung maturity. There is a common consensus that the hypertensive patients should be delivered at e”37 weeks as there is no benefit in continuing the pregnancy. For women with any type of hypertensive disorders, vaginal delivery should be considered unless cesarean section is required for the usual obstetric indication. DOI: http://dx.doi.org/10.3329/bjog.v25i1.13729 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 24-32

scholarly journals Prevalence and determinants of chronic kidney disease in women with hypertensive disorders in pregnancy in Nigeria: a cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Salisu M. Ishaku ◽  
Timothy Olusegun Olanrewaju ◽  
Joyce L. Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Gbenga A. Kayode ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gestational Hypertension ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Worldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5 and 10% of pregnancies. Sub-Saharan Africa (SSA) is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce. Methods Women with HDPs (n = 410) and normotensive women (n = 78) were recruited at delivery and prospectively followed-up at 9 weeks, 6 months and 1 year postpartum. Serum creatinine was measured at all time points and the estimated glomerular filtration rates (eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR< 60 mL/min/1.73m2 lasting for ≥ 3 months. Prevalence of CKD at 6 months and 1 year after delivery was estimated. Logistic regression analyses were conducted to evaluate risk factors for CKD at 6 months and 1 year postpartum. Results Within 24 h of delivery, 9 weeks, and 6 months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12, 5.7, 4.3% versus 0, 2 and 2.4%, respectively). The prevalence of CKD in HDPs at 6 months and 1 year postpartum was 6.1 and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age was independently shown to be a risk factor for decreased eGFR at 6 months postpartum (aOR = 1.18/year; 95%CI 1.04–1.34). Conclusion Prior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.

scholarly journals Management of hypertensive disorders in pregnancy in Black women: a systematic review

2021 ◽  
Author(s):  
Jeeva John ◽  
Gwenetta Curry
Keyword(s):  
Systematic Review ◽  
Black Women ◽  
Randomised Control Trial ◽  
Free Text ◽  
Hypertensive Disorders ◽  
Black Patients ◽  
Study Results ◽  
Hypertensive Disorders In Pregnancy ◽  
Randomised Control Trials ◽  
In Pregnancy

Abstract Background: Black women are four times more likely to die than White women due to complications during pregnancy or childbirth in the U.K. This cohort are also more prone to Hypertensive Disorders in Pregnancy (HDP). Outside of pregnancy, there are race based differences in the management of hypertension as Calcium-Channel Blockers (CCB) 9 are more effective in reducing blood pressure in Black patients. It is unclear whether these differences in anti-hypertensive management extend to the management of hypertension in pregnancy. The primary objective was to address this gap in evidence by undertaking a systematic review of all randomised control trials investigating pharmacological management of HDP to assess whether CCBs are the most effective anti-hypertensive agent in Black pregnant women. Methods: The following electronic databases were searched: PubMed, MEDLINE and Embase. We used MeSH and free text terms in conjunction to increase sensitivity to potentially relevant studies. Inclusion criteria included: (1) study involved treatment of HDP; (2) study was of a randomised control trial design; (3) one of the treatment arms involved CCBs and (4) English full-text. Information regarding baseline participant data, type of anti-hypertensive, and clinical outcomes was extracted from each study. Results: This review highlighted four randomised control trials, which published race or ethnicity demographics, with only one trial that stratified HDP outcomes by ethnicity. Conclusions: There is a lack of evidence to draw definite conclusions as to whether CCBs are the most effective anti-hypertensive agent for Black patients with HDP, highlighting the need for further research in this area. However, this review demonstrates some evidence to support the hypothesis that CCBs could be more effective in the management of HDP in Black patients and that Labetalol, which is the current first-line management of HDP, may not represent the gold standard of treatment in this cohort.

Migraine is a Risk Factor for Hypertensive Disorders in Pregnancy: A Prospective Cohort Study

Cephalalgia ◽  
2009 ◽  
Vol 29 (3) ◽  
pp. 286-292 ◽  
Author(s):  
F Facchinetti ◽  
G Allais ◽  
RE Nappi ◽  
R D'Amico ◽  
L Marozio ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Primary Headaches ◽  
Chronic Hypertension ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
History Of ◽  
In Pregnancy

The aim was to assess whether women suffering from migraine are at higher risk of developing hypertensive disorders in pregnancy. In a prospective cohort study, performed at antenatal clinics in three maternity units in Northern Italy, 702 normotensive women with singleton pregnancy at 11–16 weeks' gestation were enrolled. Women with a history of hypertensive disorders in pregnancy or presenting chronic hypertension were excluded. The presence of migraine was investigated according to International Headache Society criteria. The main outcome measure was the onset of hypertension in pregnancy, defined as the occurrence of either gestational hypertension or preeclampsia. Two hundred and seventy women (38.5%) were diagnosed with migraine. The majority (68.1%) suffered from migraine without aura. The risk of developing hypertensive disorders in pregnancy was higher in migraineurs (9.1%) compared with non-migraineurs (3.1%) [odds ratio (OR) adjusted for age, family history of hypertension and smoking 2.85, 95% confidence interval (CI) 1.40, 5.81]. Women with migraine also showed a trend to increased risk for low birth weight infants with respect to women without migraine (OR 1.97, 95% CI 0.98, 3.98). Women with migraine are to be considered at increased risk of developing hypertensive disorders in pregnancy. The diagnosis of primary headaches should be taken into account at antenatal examination.

scholarly journals Hypertensive disorders in pregnancy at the federal medical centre, Yenagoa, South-South Nigeria: a 5 year review

2021 ◽  
Vol 9 (10) ◽  
pp. 2923
Author(s):  
Peter Chibuzor Oriji ◽  
Dennis Oju Allagoa ◽  
Akaninyene Eseme Ubom ◽  
Amos Kattey Kattey ◽  
Datonye Christopher Briggs ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Case Fatality ◽  
Medical Centre ◽  
Morbidity And Mortality ◽  
Chronic Hypertension ◽  
Maternal Deaths ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Gestational Age At Delivery ◽  
In Pregnancy

Background: Hypertensive disorders complicate 5.2%-8.2% of pregnancies, and contribute significantly to perinatal and maternal morbidity and mortality worldwide. To determine the incidence, clinical characteristics, maternal and perinatal outcomes of hypertensive disorders in pregnancy at the Federal medical centre, Yenagoa, Bayelsa State, South-South Nigeria.Methods: This retrospective study was conducted between 1 January, 2016 and 31 December, 2020. Relevant data was retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0.Results: Out of the 4,571 obstetric patients that were managed in our Centre in the period under review, 335 of them had HDP, giving an incidence rate of 7.32%.The most common HDP were pre-eclampsia (189, 56.4%) and eclampsia (82, 24.5%), while the least common was chronic hypertension (3, 0.9%). A little more than one-half (171, 51.0%) of the women delivered preterm, with a mean gestational age at delivery of 35.5 weeks. The most common route of delivery was emergency Caesarean section (205, 61.2%). There were three maternal deaths, giving a case fatality rate of 0.9%. Two of the maternal deaths were due to eclampsia, and one, from pre-eclampsia.Conclusions: Women should be adequately counseled to embrace preconception care, and early and regular antenatal care visits, with proper monitoring of blood pressure and urine protein. Prompt diagnosis and management are key in preventing the maternal and perinatal morbidity and mortality that are associated with these disorders. 

scholarly journals Immediate Perinatal Outcome of Neonates with Maternal Hypertensive Disorders in Pregnancy

2013 ◽  
Vol 33 (3) ◽  
pp. 190-195
Author(s):  
Mahmuda Hassan ◽  
Ferdousi Choudhury ◽  
Marium Begum ◽  
Hamidur Rahman ◽  
Sayeba Akhter
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Perinatal Outcome ◽  
Gestational Hypertension ◽  
Positive Family History ◽  
Normal Vaginal Delivery ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Hypertensive Disorders ◽  
Hypertensive Disorder Of Pregnancy

Introduction: Hypertensive disorders of pregnancy seem to be one of the major causes of maternal morbidity and mortality leading to 10-15% of maternal deaths especially in the developing world. This study examines the perinatal outcome of neonates with mothers having hypertensive disorder of pregnancy. Materials and Methods: Seventy three mothers and their newborn babies were selected. Mothers with Gestational hypertension, preeclampsia, eclampsia, chronic hypertension, preeclampsia superimposed on chronic hypertension were included. Gestational diabetics (GDM), chronic maternal diseases, infant of diabetic mother (IDM), babies with major congenital malformations were excluded. Results: Thirty five mothers (47.9%) had regular antenatal check up (ANC) and 38 (52%) had irregular. Nineteen mothers (26%) were primipara and 54 (74%) were multipara. Forty four mothers (60%) had positive family history or had own history of hypertensive disorder during their previous pregnancy. 13 mothers (17.8%) had normal vaginal delivery (NVD), 60 mothers (82.19%) had lower uterine cesarean section (LUCS). 30 babies (41%) were admitted. 44 mothers (60%) had gestational hypertension, 21 had (28.6%) pre-eclamtic toxemia (PET), 3 had (4.1%) eclampsia, 5 had (6.8%) essential hypertension 3 of them subsequently developed PET. Mean maternal age 26.86 years, gestational age 34.15 (±1.46)weeks among admitted and 36.30 (±1.6)weeks among non-admitted group. Mean birth weight was 1.69 (±0.39) kg. among admitted and 2.71 (±0.31) kg. in non-admitted babies. Seven pregnancies (9.58%) were twin, macerated 1 twin among was among 2 pregnancies (2.7%), 5 intra uterine death (IUD) observed in single pregnancy. Conclusion: Significant number of babies with maternal hypertensive disorder of pregnancy needed hospitalization, mean birth weight and gestational age was less than that of the non-admitted group. DOI: http://dx.doi.org/10.3126/jnps.v33i3.9252   J. Nepal Paediatr. Soc. 2013;33(3):190-195

scholarly journals Occupational Risk Factors and Hypertensive Disorders in Pregnancy: A Systematic Review

2021 ◽  
Vol 18 (16) ◽  
pp. 8277
Author(s):  
Emanuela Spadarella ◽  
Veruscka Leso ◽  
Luca Fontana ◽  
Angela Giordano ◽  
Ivo Iavicoli
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Job Strain ◽  
Gestational Hypertension ◽  
Occupational Risk Factors ◽  
Occupational Risks ◽  
Hypertensive Disorders ◽  
Evidence Quality ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Hypertensive disorders in pregnancy (HDP), including gestational hypertension (GH) and preeclampsia (PE), characterize a major cause of maternal and prenatal morbidity and mortality. In this systematic review, we tested the hypothesis that occupational factors would impact the risk for HDP in pregnant workers. MEDLINE, Scopus, and Web of Knowledge databases were searched for studies published between database inception and 1 April 2021. All observational studies enrolling > 10 pregnant workers and published in English were included. Un-experimental, non-occupational human studies were excluded. Evidence was synthesized according to the risk for HDP development in employed women, eventually exposed to chemical, physical, biological and organizational risk factors. The evidence quality was assessed through the Newcastle–Ottawa scale. Out of 745 records identified, 27 were eligible. No definite conclusions could be extrapolated for the majority of the examined risk factors, while more homogenous data supported positive associations between job-strain and HDP risk. Limitations due to the lack of suitable characterizations of workplace exposure (i.e., doses, length, co-exposures) and possible interplay with personal issues should be deeply addressed. This may be helpful to better assess occupational risks for pregnant women and plan adequate measures of control to protect their health and that of their children.

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