scholarly journals Maternal and perinatal outcome in pregnant women with hypertensive disorders: a population-based study

2019 ◽  
Vol 9 (1) ◽  
pp. 194
Author(s):  
S. Shruthi ◽  
G. Thenmozhi
Keyword(s):  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
Population Based ◽  
Severe Preeclampsia ◽  
Chronic Hypertension ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Hypertensive Disorders ◽  
Fetal Complications

Background: Hypertension during pregnancy is one of the well-known complications of dating from ancient times. It remains as one of the leading causes of maternal mortality and morbidity through its myriad complications. To study the risk factors, prevalence and epidemiological parameters of antenatal mothers presenting with hypertension during pregnancy.Methods: This study was on hypertensive disorders of pregnancy including mild, severe preeclampsia, eclampsia, and chronic hypertension at Chengalpattu Medical College Hospital, Chengalpattu in a period of 1st year from October 2016 to September 2017.Results: Out of 450 hypertensive pregnancies, the majority were severe preeclampsia (39.6%). There were 78 women with gestational hypertension (17.3%), 125 women with mild preeclampsia (27.8%), 178 women with severe preeclampsia (39.6%), 64 women with eclampsia out of which 52 were AP eclampsia (11.6%), 1 case was IP eclampsia (0.2%) and 11 women were PP eclampsia (2.4%). 5 women were chronic hypertensives (1.1%)Conclusions: Complications can affect all maternal systems including central nervous system, renal system, and hematological systems. Apart from these, the fetus also faces the brunt of insult. Fetal complications include prematurity, low birth weight, stillbirths, intrauterine deaths, and intrauterine growth restrictions. However, such vast complications can be prevented by simple blood pressure monitoring and proper antenatal mother follow-up.

scholarly journals Comparative study of labetalol and nifedipine in management of non- severe preeclampsia and its fetomaternal outcome

2019 ◽  
Vol 8 (5) ◽  
pp. 2034
Author(s):  
Delphine T. Rose ◽  
Jeyarani P.
Keyword(s):  
Blood Pressure ◽  
Tamil Nadu ◽  
Neonatal Outcome ◽  
Developed Countries ◽  
Severe Preeclampsia ◽  
Chronic Hypertension ◽  
Maternal Deaths ◽  
Medical College ◽  
Hypertensive Disorders ◽  
Significant Difference

Background: In developed countries, 16 percent of maternal deaths were attributed to hypertensive disorders. Of hypertensive disorders, the preeclampsia syndrome, either alone or superimposed on chronic hypertension, is the most dangerous. The incidence of preeclampsia in nulliparous populations ranged from 3 to 10 percent.Methods: The present study was conducted at Government Raja Mirasudhar Hospital, Thanjavur Medical College, Thanjavur, Tamil Nadu, India from October 2017 to October 2018. The study consisted of 100 antenatal women with non-severe preeclampsia. The efficacy of labetalol verses nifedipine in its management was studied along with the fetomaternal outcome.Results: In this study, in the labetalol and in the nifedipine groups adequate control of blood pressure was achieved. However, labetalol was well tolerated by our women without much side effects.Conclusions: The present study indicates both labetalol and nifedipine are equally efficacious in the control of hypertension in non-severe preeclampsia. Pathology of the disease was not altered significantly in both the groups. There was no significant difference in the neonatal outcome between the two groups.

scholarly journals Correlation Between Divided Doses of Chronic Antihypertensive Drugs and Pregnancy Outcomes

2017 ◽  
Vol 8 (3) ◽  
pp. 328-332
Author(s):  
Safura Hatamipour Dehno ◽  
Simin Taghavi ◽  
Nayyereh Ayati
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Antihypertensive Drugs ◽  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Pressure Monitoring ◽  
Fetal Complications

Objectives: Hypertension, as a common problem during pregnancy, is a major cause of maternal and fetal morbidity and mortality. Anti-hypertensive drugs are used to prolong the pregnancy or modify perinatal outcomes in pregnant women with hypertensive disorders. Severe monitoring of blood pressure is subsequently essential in these mothers. The aim of this study was to evaluate the correlation between divided doses of chronic hypertensive drugs and the end of pregnancy in mothers with gestational hypertension. Materials and Methods: In this prospective research, 99 pregnant women with chronic hypertension, who were treated with antihypertensive medicines, were studied during pregnancy. During routine follow-up of these mothers, the number of the drug and the divided doses were recorded. The incidence of maternal and fetal outcomes were evaluated according to the number of less or more than 5 divided doses. Results: Maternal and fetal-baby complications were observed in 5.50 and 5.53% cases, respectively. The incidence of maternal and fetal complications were significantly enhanced by increasing the number of up-taken anti-hypertensive drugs. The maternal and fetal-baby complications were higher in mothers who received more than five divided doses compared to those who received less than five doses. Conclusion: Based on our results, chronic hypertension was associated with maternal and fetal-baby complications in half of the cases. It is clarified that precise blood pressure monitoring and regularly taking of anti-hypertensive medicine may decrease the hypertension side effects. The awareness about this field in the pre-pregnancy consulting is considered as the patients’ rights and should be respected.

scholarly journals Risk factors of thrombocytopenia in pregnancy

2017 ◽  
Vol 6 (2) ◽  
pp. 700
Author(s):  
Ayisha Begam ◽  
Sujatha TL ◽  
Bindu Nambisan ◽  
Vasanthakumari KP
Keyword(s):  
Risk Factors ◽  
Gestational Hypertension ◽  
Dengue Infection ◽  
Third Trimester ◽  
College Hospital ◽  
Medical College ◽  
Hypertensive Disorders ◽  
Gestational Thrombocytopenia ◽  
Control Study ◽  
In Pregnancy

Background: Thrombocytopenia in pregnancy occurs due to several etiologies which include both pregnancy specific and non pregnancy related causes. It is second only to anemia as the most common hematological abnormality encountered in pregnancy. Better antenatal care has led to increased detection. Once diagnosed, it is important to further evaluate and to determine the cause to optimize management. Several studies have been undertaken across the world; however there are very few studies in Kerala hence this study. The aim of this study was to determine the risk factors of thrombocytopenia in pregnancy.Methods: This was a case control study undertaken in the Department of Obstetrics and Gynecology, Medical college Hospital, Trivandrum, Kerala. Using purposive sampling, a sample size of 96 cases and 96 controls were included in this study. “Cases” were antenatal women with thrombocytopenia and “controls” were consecutive women without it. Study period was 18 months and analysis was done using SPSS version 22.Results: In 49% of subjects ,the cause was identified as gestational thrombocytopenia,39.5% cases were due to hypertensive disorders of pregnancy.10.4% was due to ITP. SLE, AFLP, Dengue infection, HUS and APLA were rare causes of thrombocytopenia in our hospital. Of the 96 cases enrolled in the study,88 were diagnosed during pregnancy. Amongst the hypertensive disorders,16.7% was due to gestational hypertension,10.4% due to preeclampsia and 7.4% were due to HELLP syndrome.82.3% of patients with thrombocytopenia in this study were asymptomatic.Conclusions: Thrombocytopenia should be evaluated by making a practice of routinely checking the platelet count and peripheral smear in early pregnancy and also in third trimester to enable early diagnosis since most cases may be asymptomatic.

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 Maternal morbidity of adolescent pregnant women

2021 ◽  
Vol 64 (6) ◽  
pp. 10-12
Author(s):  
Carlos Arturo Paniagua Coahuila ◽  
◽  
José Anaya Herrera ◽  
Dulce Alejandra Alonso Lozano ◽  
Lenny Pinña Guerrero ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Severe Preeclampsia ◽  
Advanced Trauma Life Support ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Obstetric Hemorrhage ◽  
Childbearing Age ◽  
Adolescent Population ◽  
Hypertensive Disorders

Background: In Mexico, it is estimated that the adolescent population represents 29% of the population of childbearing age. The present study aimed to analyze the obstetric results of 3310 adolescent pregnant women attended in a third level hospital. Material and methods: All records of pregnant women aged 19 years or less up to the date of admission were analyzed at the Mónica Pretelini Saenz Maternal Perinatal Hospital during the period from January 2018 to June 2020, with the following variables: age, pregnancy, resolution obstetric, severe preeclampsia, preeclampsia and gestational hypertension. Results: A total of 13874 pregnant women were attended, of which 3310 (24%) patients were adolescents. The overall frequency of obstetric complications was 21%, including obstetric hemorrhage (13%) and hypertensive disorders of pregnancy (8%). Regarding postpartum obstetric hemorrhage events, classified according to the Advanced Trauma Life Support shock scale, they were categorized as Grade 1 – 338 cases, Grade II – 76 cases, Grade III – 11 cases and Grade IV – 1 case. Hypertensive disorders of pregnancy highlight preeclampsia as the most frequent with a total of 97 cases, followed by 89 cases of severe preeclampsia, 58 cases of gestational hypertension, 14 cases of chronic hypertension and 3 cases of chronic hypertension with preeclampsia. Conclusions: The main complications found in the Mexican pregnant adolescent population were obstetric hemorrhage, which was more frequent in the population aged 15 to 19 years, and hypertensive disorders, which occurred more frequently in the population aged 9 to 14 years.

PRE-ECLAMPSIA AS A MARKER OF CARDIOVASCULAR DISEASE

2008 ◽  
Vol 19 (4) ◽  
pp. 271-292 ◽  
Author(s):  
LA MAGEE ◽  
J NEWSTEAD ◽  
J NG ◽  
AM CÔTÉ ◽  
P VON DADELSZEN
Keyword(s):  
Cardiovascular Disease ◽  
Maternal Mortality ◽  
Gestational Hypertension ◽  
Population Based ◽  
Medical Complication ◽  
Hypertensive Disorders Of Pregnancy ◽  
Mortality And Morbidity ◽  
Hypertensive Disorders ◽  
Maternal Mortality And Morbidity ◽  
In Pregnancy

Cardiovascular disease is the leading cause of death in women. The hypertensive disorders of pregnancy (HDP) are the most common medical complication of pregnancy, complicating up to 10% of pregnancies worldwide. They represent a leading cause of maternal mortality and morbidity in pregnancy. The most common of these disorders is gestational hypertension (5–6%). Using population-based data, approximately 1% of pregnancies are complicated by pre-existing hypertension, 5–6% by gestational hypertension without proteinuria, and 1–2% by pre-eclampsia.

Basal Plate Myometrial Fibers and Hypertensive Disorders of Pregnancy: A Case–Control Study

2017 ◽  
Vol 21 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Ann A Wang ◽  
Linda M Ernst ◽  
Emily S Miller
Keyword(s):  
Case Control Study ◽  
Gestational Hypertension ◽  
Case Control ◽  
Basal Plate ◽  
Common Finding ◽  
Pathological Examination ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Control Study

Introduction Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling. Methods This case–control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination. Cases were women with HDP (gestational hypertension, preeclampsia, or HELLP syndrome) as defined by American College of Obstetricians and Gynecologists. Controls were women without HDP. Women with chronic hypertension were excluded. The primary outcome was the presence of BPMYO. Secondary outcomes included the pathologic stage of BPMYO and the incidence of pathologically defined accreta. Each outcome was compared between cases and controls in bivariable and multivariable analyses. Results Of the 306 women who met inclusion criteria, 230 (75%) had HDP. BPMYO was present in 99 (32%) of placentas. Compared to controls, cases were younger, had higher body mass index, and were more likely to have diabetes, be nulliparous, deliver preterm, and have had a prior cesarean. There were no differences in the incidence of BPMYO, stage of BPMYO, or incidence of pathologically defined accreta between cases and controls. These findings persisted after controlling for potential confounders. Conclusions Although BPMYO may be more common in the setting of abnormal placental vasculature, there is no significant association between BPMYO and HDP.

scholarly journals Causes and management of secondary postpartum haemorrhage in a tertiary medical college hospital in Bangladesh

2017 ◽  
Vol 6 (7) ◽  
pp. 2694
Author(s):  
Kamrun Nessa ◽  
Sumia Bari ◽  
Sanjida Khan ◽  
Ferdowsi Sultana ◽  
Tania Akbar
Keyword(s):  
Maternal Morbidity ◽  
Postpartum Haemorrhage ◽  
Mode Of Delivery ◽  
Wound Dehiscence ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Maternal Mortality And Morbidity ◽  
Postnatal Women ◽  
Low Incidence

Background: Globally postpartum haemorrhage remains a leading cause of maternal death. It affects only 1-2% of postnatal women. This low incidence of secondary PPH and linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increase morbidity and mortality related to secondary PPH.Methods: A retrospective study was conducted on the diagnosed patients of secondary PPH admitted in Enam Medical College and Hospital, Dhaka, Bangladesh, from January 2015 to December 2016. Among 33 cases of secondary PPH age of the patients, parity, mode of delivery, causes and management were noted from medical records. All data was analyzed by SPSS16.Results: Among 33 patients 14 (42.4%) were primi and 19 (57.6%) were multipara, age between 18 to 38 years, majority admitted 2nd and 3rd week after delivery. Among 33 patients 12% delivered vaginally at home and 30% vaginally at hospital and 58% undergone LUCS. We found 34% retained bits of placenta, 27% uterine wound dehiscence, 24% retained clots and 15% endometritis as causes. Less than 3 units blood needed in 22 (66.7%) patients and 11 (33.3%) needed more than 3 units. About 6 (18%) patients were treated conservatively, MVA were needed in 18 (55%) patients, repair of wound in 4 (12%) and TAH was in 5 (15%).Conclusions: Secondary PPH is increasing may result in significant maternal morbidity as well as mortality. More study needed to identify the risk factors and causes to reduce maternal mortality and morbidity.

scholarly journals Risk factor Analysis and Angiographic Profiles in First 228 Cases Undergone Coronary Angiography in Cardiac Cath Lab of Dhaka Medical College Hospital

1970 ◽  
Vol 3 (2) ◽  
pp. 122-125 ◽  
Author(s):  
AEMM Islam ◽  
M Faruque ◽  
AW Chowdhury ◽  
HIR Khan ◽  
MS Haque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Coronary Angiography ◽  
Medical Therapy ◽  
Stable Angina ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Single Vessel

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125

scholarly journals Hypertensive Disorders during Pregnancy and Risk of Bronchopulmonary Dysplasia in Very Preterm Infants

2018 ◽  
Vol 36 (02) ◽  
pp. 176-183
Author(s):  
Filipa de Lima ◽  
Ana Machado ◽  
Hercília Guimarães ◽  
Gustavo Rocha ◽  
Keyword(s):  
Arterial Hypertension ◽  
Preterm Infants ◽  
Bronchopulmonary Dysplasia ◽  
Gestational Hypertension ◽  
Newborn Infants ◽  
Chronic Hypertension ◽  
Very Preterm Infants ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Preterm Babies

Introduction It is not yet fully known whether hypertensive disorders (HTD) during pregnancy impose an increased risk of development of bronchopulmonary dysplasia (BPD) in preterm newborn infants. Objective To test the hypothesis that preeclampsia and other HTD are associated with the development of BPD in preterm infants. Materials and Methods Data on mothers and preterm infants with gestational age 24 to 30 weeks were prospectively analyzed in 11 Portuguese level III centers. Statistical analysis was performed using IBM SPSS statistics 23. Results A total of 494 preterm infants from 410 mothers were enrolled, and 119 (28%) of the 425 babies, still alive at 36 weeks, developed BPD. The association between chronic arterial hypertension, chronic arterial hypertension with superimposed preeclampsia, and gestational hypertension in mothers and BPD in preterm infants was not significant (p = 0.115; p = 0.248; p = 0.060, respectively). The association between preeclampsia–eclampsia and BPD was significant (p = 0.007). The multivariate analysis revealed an association between preeclampsia–eclampsia and BPD (odds ratio [OR] = 4.6; 95% confidence interval [CI] 1.529–13.819; p = 0.007) and a protective effect for BPD when preeclampsia occurred superimposed on chronic arterial hypertension in mothers (OR = 0.077; 95%CI 0.009–0.632; p = 0.017). Conclusion The results of this study support the association of preeclampsia in mothers with BPD in preterm babies and suggest that chronic hypertension may be protective for preterm babies.

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