scholarly journals Drug utilization study of antihypertensive drugs used in the treatment of second and third trimester of pregnancy in tertiary care hospital

2018 ◽  
Vol 7 (9) ◽  
pp. 1733
Author(s):  
Shrikant B. Lahamate ◽  
Syed U. Razvi ◽  
Mirza S. Baig ◽  
Sudhakar M. Doifode
Keyword(s):  
Drug Therapy ◽  
Antihypertensive Drugs ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Multiple Drug ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Hypertensive Disorders ◽  
Multiple Drug Therapy ◽  
In Pregnancy

Background: Hypertensive disorders are major cause of the perinatal and maternal mortality and morbidity worldwide. Aim of study was to evaluate current trend of antihypertensive drugs and to assess frequency and distribution of antihypertensive drugs in pregnancy.Methods: A retrospective observational study was conducted in a tertiary care hospital for period of six months in collaboration with department of obstetrics and gynaecology. Patients data recorded in case report form and analysed to study prescription pattern and related information.Results: Total of 104 cases were enrolled in this study. Prescribed antihypertensive drugs in pregnancy were Labetalol, Nifedipine, MgSO4 and furosemide. Most commonly prescribed drug was labetalol. In this study, Gestational hypertension was most common diagnosis in hypertensive disorder. Majority of drug prescribed from category C and A. In present study, Single drug therapy was most commonly prescribed for hypertension in pregnancy was 64.42% whereas multiple drug therapy was 35.57%. Most common maternal complication was anaemia i.e. 54.05% followed by placental abruption in 24.3%. Neonatal outcome was low birth weight i.e.36% followed by preterm birth i.e.24%.Conclusions: Labetalol found to be most common prescribed drug. Single drug therapy prescription was high as compared to multiple drug therapy prescription in hypertensive disorders in pregnancy. Gestational hypertension was most common cause of hypertensive disorder. Anaemia was found to be most common maternal complication encountered in hypertensive disorders in pregnancy. Most common adverse neonatal outcome was low birth weight.

scholarly journals Prevalence of hypertensive disorders of pregnancy and its maternal outcome in a tertiary care hospital, Salem, Tamil Nadu, India

2019 ◽  
Vol 9 (1) ◽  
pp. 236
Author(s):  
Subha Sivagami Sengodan ◽  
Sreeprathi N.
Keyword(s):  
Tamil Nadu ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Complications ◽  
Hypertensive Disorders ◽  
Obstetrics And Gynaecology

Background: Hypertensive disorders complicate 5-10% of all pregnancies and together forms the deadly triad- along with hemorrhage and heart disease that contributes greatly to maternal morbidity and mortality. Objective of this study was to determine the prevalence of hypertensive disorders of pregnancy and its maternal complications in patients attending obstetrics and gynaecology department, Government Mohan Kumaramangalam Medical College Hospital, Salem.Methods: This is a prospective study conducted from August 2018 to July 2019 in the department of obstetrics and gynaecology. Patients diagnosed with hypertensive disorders of pregnancy was evaluated and data were collected.Results: A total of 19,383 pregnant women visited obstetrics and gynaecology department over a period of one year, out of which 2028 were diagnosed with hypertensive disorders of pregnancy. Hence the prevalence of hypertensive disorders in pregnancy is 10.4%. Among 2028 hypertensive disorder cases, Gestational hypertension were 962 cases (47.4%), pre-eclampsia 661 cases (32.6%), chronic hypertension 166 cases (8.2%) and pre-eclampsia superimposed on chronic hypertension 239 cases (11.8%). The prevalence was highest among primigravida (54%) compared to multigravida (46%). Hypertensive disorders were highest among the age group of 18-22 years in our study. Most common maternal complication in our study was HELLP syndrome.Conclusions: Prevalence of hypertensive disorders was high in our study. Early detection and timely intervention decrease the maternal complications.

scholarly journals Implementation and evaluation of adverse drug reaction monitoring system in a tertiary care teaching hospital in Mumbai, India

2013 ◽  
Vol 6 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Dindayal Patidar ◽  
Mithun S. Rajput ◽  
Nilesh P. Nirmal ◽  
Wenny Savitri
Keyword(s):  
Drug Therapy ◽  
Adverse Drug Reactions ◽  
Drug Exposure ◽  
Improve Patient Safety ◽  
Tertiary Care ◽  
Good Method ◽  
Morbidity And Mortality ◽  
Multiple Drug ◽  
Drug Reactions ◽  
Multiple Drug Therapy

Abstract Adverse drug reactions (ADR) are a significant cause of morbidity and mortality, often identified only post-marketingly. Improvement in current ADR reporting, including utility of underused or innovative methods, is crucial to improve patient safety and public health. Hospital-based monitoring is one of the methods used to collect data about drug prescriptions and adverse events. The aims of this study were to identify the most frequent ADRs recognized by the attending physicians, study their nature, and to target these ADRs in order to take future preventive measures. A prospective study was conducted over a 7-month period in an internal medicine department using stimulated spontaneous reporting for identifying ADRs. Out of the 254 admissions, 32 ADRs in 37 patients (14.56%) were validated from the total of 36 suspected ADRs in 41 patients. Female predominance was noted over males in case of ADRs. Fifty percent of total ADRs occurred due to multiple drug therapy. Dermatological ADRs were found to be the most frequent (68.75%), followed by respiratory, central nervous system and gastrointestinal ADRs. The drugs most frequently involved were antibiotics, antitubercular agents, antigout agents, and NSAIDs. The most commonly reported reactions were itching and rashes. Out of the 32 reported ADRs, 50% of the reactions were probable, 46.87% of the reactions were possible and 3.12% of the reactions were definite. The severity assessment done by using the Hartwig and Seigel scale indicated that the majority of ADRs were ‘Mild’ followed by ‘Moderate’ and ‘Severe’ reactions, respectively. Out of all, 75% of ADRs were recovered. The most potent management of ADRs was found to be drug withdrawal. Our study indicated that hospital based monitoring was a good method to detect links between drug exposure and adverse drug reactions. Adequate training regarding pharmacology and optimization of drug therapy might be helpful to reduce ADR morbidity and mortality.

scholarly journals Prospective study of fetomaternal outcome in epilepsy in pregnancy in a tertiary care hospital

2017 ◽  
Vol 6 (11) ◽  
pp. 5055
Author(s):  
Raji C. ◽  
Sekar D.
Keyword(s):  
Prospective Study ◽  
Tamil Nadu ◽  
Cleft Lip ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Live Birth Rate ◽  
Care Hospital ◽  
College Hospital ◽  
Pregnancy And Childbirth ◽  
In Pregnancy

Background: Epilepsy is the second most common neurological disorder in obstetrics after migraine. There are conflicting reports about the effect of epilepsy on pregnancy. Objective of present study was to evaluate fetomaternal outcome in patients with epilepsy.Methods: This prospective study was conducted in Government Thanjavur medical college hospital, Tamil Nadu, India over a period of 15 months from January 2015 to March 2016 in all epilepsy cases. Total 110 epilepsy cases were admitted. In all cases maternofetal outcome were noted.Results: This study showed that the incidence of epilepsy in pregnancy in our hospital is 0.6%. 86.36% of patients were treated with antiepileptic medications during their pregnancies.  Pregnancy complications were anemia, gestational diabetes mellitus, gestational hypertension, intrauterine growth retardation, premature rupture of membrane, and vaginal bleeding. Live birth rate was 91.82%.  Low birth weight babies were recorded in 24 (21.82%) infants. Only one baby had congenital anomaly of cleft lip and palate.Conclusions: There was no significant increase in the risk of complications of pregnancy or delivery.Frequency of cesarean section is not increased in epileptic patients. There is no undue risk to pregnancy and childbirth in most of the cases.

scholarly journals Maternal Near Miss Events in Tertiary Care Hospital: A Retrospective Observational Study

2021 ◽  
Author(s):  
Sonali J Ingole ◽  
Shilpa N Chaudhary
Keyword(s):  
Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Hypertensive Disorders ◽  
Obstetric Haemorrhage ◽  
In Pregnancy

Introduction: Over the years, continuous efforts have been made for improving reproductive health status of women. In India, Ministry of Health and Family Welfare (MoHFW) has set Maternal Near Miss (MNM) review operational guidelines. Aim: Analysis of the incidence and causes of MNM cases in tertiary care hospital. Materials and Methods: This retrospective observational study was undertaken at a tertiary care hospital from January 2010 to September 2018. MNM cases were identified according to the criteria given by MoHFW, MNM review operational guidelines. Following parameters (variables) were noted viz., age, parity, obstetric haemorrhage, severe anaemia, sepsis, therapeutic interventions, etc., and analysed. Quantitative data was analysed by calculating means, ratios and proportions, using SPSS software (Version 21.0). Results: There were total 36,366 deliveries during the study period. A total of 315 Maternal Near Miss cases were noted. Hypertensive disorders n=133 (42.2%) in pregnancy was the leading cause of MNM events at the hospital. This was followed by obstetric haemorrhage n =97 (30.79 %), and severe anaemia constituting n=36 (11.42%), and Sepsis n=30 (9.52%). Mortality index was highest in the sepsis group n=5 (14.28%) followed by severe anaemia n=3 (7.69%). Conclusion: Hypertensive disorders were most common cause of near miss cases followed by obstetric haemorrhage. Sepsis was commonest cause of maternal mortality. Early identification of hypertensive disorders in pregnancy, obstetric haemorrhage, severe anaemia and sepsis; and prompt treatment of these causes may help in reducing near miss and maternal mortality.

Feto-maternal Outcome in Pregnancies Complicated by Hypertensive Disorder: A Retrospective Study at a Tertiary Care Centre of Eastern Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1127-1131
Author(s):  
Gyanendra Man Singh Karki ◽  
Mona Priyadarshini ◽  
Tarun Pradhan
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
College Teaching ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Morbidity And Mortality ◽  
Hypertensive Disorder ◽  
Care Hospital ◽  
Hypertensive Disorders ◽  
Heart Rate Pattern

Introduction: Hypertensive disorder of pregnancy is one of the major cause of maternal and fetal morbidity and mortality. Objective: The objective of this study was to estimate the associated maternal and fetal outcome and complications in pregnancies complicated by hypertensive disorders at a tertiary care hospital in eastern Nepal. Methodology: This retrospective cross section observational study included purposely-selected one hundred thirty four pregnant women from April 2019 to April 2020 in the Department of Obstetrics and Gynaecology at Birat Medical College Teaching Hospital, Tankisinuwari, Morang, Nepal. Maternal age, gravidity, period of gestation at presentation, associated maternal comorbidities/ risk factors, mode of delivery, indication for surgery, maternal outcome and complications, fetal outcome was recorded and data was analysed using SPSS version 23 software. Result: Out of the 134 study population,35.8% of the mothers with hypertensive disorders were noted in the age group between 25-29 years and almost two third of the patients were multigravida. 55.2% patients had mild, while 44.8% had severe hypertension. About 83.6% of the hypertensive pregnant mothers delivered preterm between 33 to 36 weeks of gestation. 61.9% mothers underwent cesarean section with the most common indication being non-reassuring fatal heart rate pattern, while 34.3% women delivered vaginally. 86 out of 134 cases did not develop any complications while, postpartum haemorrhage was the most frequently encountered complication seen in 17.9% cases followed by eclampsia encountered in 13.4% patients. The mortality encountered was 0.7%. Neonatal complications were found in 50% cases, 15.7% neonates had low APGAR score and 8.2% had meconium aspiration, while 4.5% intrauterine deaths and 3% neonatal deaths were observed. Conclusion: There is adverse impact of hypertension during pregnancy over maternal and perinatal outcome. Hence, early identification and prompt referral to the well-equipped center is necessary to reduce the associated morbidity and mortality.

scholarly journals A correlation of lactate dehydrogenase enzyme levels in pregnancy induced hypertensive disorders with severity of disease, maternal and perinatal outcome

2017 ◽  
Vol 6 (10) ◽  
pp. 4302 ◽  
Author(s):  
Neha V. Bhave ◽  
Parmanand K. Shah
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Vascular Function ◽  
Perinatal Outcome ◽  
Gestational Hypertension ◽  
Hypertensive Disorder ◽  
Severity Of Disease ◽  
Hypertensive Disorders ◽  
Dehydrogenase Enzyme ◽  
In Pregnancy

Background: A spectrum of hypertensive disorders in pregnancy contribute to maternal and perinatal morbidity and mortality. For prediction and early diagnosis of preeclampsia various biochemical markers, vascular function test and renal markers have been developed. The objective of the study is to measure the lactate dehydrogenase enzyme (LDH) levels in pregnant women with pregnancy induced hypertensive disorders and correlate the levels with the severity of condition, maternal and the perinatal outcome.Methods: In this prospective observational study, a total of 150 pregnant women were studied. Out of these 150 women, 30 women had normal blood pressure, 30 women had gestational hypertension, 30 women had mild preeclampsia, 30 women had severe preeclampsia and 30 women had eclampsia. The serum LDH levels were measured in third trimester and patients followed up until early postpartum period and babies were followed up till early neonatal period to assess the maternal and neonatal outcomes.Results: Higher lactate dehydrogenase enzyme (LDH) levels were observed in pregnant women with severe form of hypertensive disorder and those who had a poor maternal and perinatal outcome. This is statistically significant (p<0.001).Conclusions: Lactate dehydrogenase enzyme (LDH) level is a useful biochemical marker to assess and predict the severity of disease, maternal and perinatal outcome as higher levels of the enzyme are associated with worsening severity of disease, a poor maternal and perinatal outcome.

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 Prospective study on prescribing pattern of antihypertensive drugs at a tertiary care hospital

2018 ◽  
Vol 7 (11) ◽  
pp. 2126
Author(s):  
Vishwanath M. ◽  
Murgesh J. V. ◽  
Arpitha D. ◽  
Nithiya D.
Keyword(s):  
Drug Therapy ◽  
Tertiary Care Hospital ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Case Record ◽  
Health Maintenance ◽  
Number Of Patients ◽  
Wide Range

Background: Hypertension is the leading non-communicable disease risk attributing to cardio vascular morbidity and mortality. Various reasons are socio-economic, behavioural, sedentary life style, nutritional, age, obesity and poor health maintenance. A wide range of antihypertensive drugs belonging to different pharmacological classes are available alone or in combinations. Present study was done to evaluate the prescribing pattern of antihypertensive drugs at a tertiary care hospital.Methods: A prospective, observational, non-interventional, hospital-based study was carried out in hypertensive patients attending outpatient department of General Medicine at Medical College Hospital attached to Vijayanagar Institute of Medical Sciences, Ballari. Data was collected from outpatient slip of patients in a predesigned case record form, which was analysed using descriptive statistics.Results: Among 200 patients analysed 95 (47.5%) were males and 105 (52.5%) were females, with maximum number of patients falling in the age group 61-70years. Among antihypertensives prescribed, amlodipine (78.5%) was most frequently prescribed drug. Frequently used drugs for monotherapy - amlodipine (37.5%), for two drug therapy - amlodipine + atenolol (25.5%), and for three drug therapy - amlodipine + atenolol + telmisartan (2.5%). WHO prescribing indicators: Average number of drugs per encounter is 2.38 (±1.19). Percentage of drugs prescribed by generic name is 76.47%. Percentage of drugs prescribed from essential drug list is 97.89%.Conclusions: Present study shows current trends in prescription of antihypertensives in tertiary care hospital and their rational use. Study emphasizes need for preventive and educative measures about hypertension in population.

scholarly journals Study of medical disorders in pregnancy among in patients at a tertiary care hospital in Haryana, India

2019 ◽  
Vol 8 (9) ◽  
pp. 3770
Author(s):  
Sushila Chaudhary ◽  
Savita Rani Singhal ◽  
Meenakshi B. Chauhan ◽  
Anjali Gupta ◽  
Monika Dalal
Keyword(s):  
Tertiary Care Hospital ◽  
Stress Test ◽  
Tertiary Care ◽  
Liver Disorder ◽  
Team Approach ◽  
Care Hospital ◽  
Medical Disorders ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Background: Pregnancy is a physiological condition in which various changes occur in pregnant women just to accommodate growing fetus. Pregnancy is a stress test for woman and may unmask certain underlying chronic diseases like, DM, hypertension which were silent or asymptomatic prior to pregnancy. This study was done to know the incidence, type and demographic profile of medical disorders in pregnancy among in patient at a tertiary care hospital.Methods: It was a retrospective study conducted on 578 patients of medical disorders in pregnancy admitted in a tertiary care hospital from January 2017 to December 2017. Data collected from record room and analysis done.Results: Total antenatal admissions were 4721. Incidence of medical disorders was 12.24%. Majority of women were in age group 20-30 years (65.5%). Low-parity (P0, P1). Hypertensive disorders in pregnancy was commonest reported disorder (42.3%), followed by hematological disorder (38.7%), liver disorder 5%, endocrine disorder 4.8%, epilepsy 3.8% and HIV 2.6% in present study.Conclusions: Hypertensive disorders were commonest medical disorder followed by hematological, liver, endocrine and epilepsy. All medical disorders in pregnancy to be managed by team approach.

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