scholarly journals Feto-maternal outcome in COVID-19 positive patients with hypertensive disorders in pregnancy

2021 ◽  
Vol 10 (5) ◽  
pp. 1846
Author(s):  
Niranjan N. Chavan ◽  
Hera S. Mirza ◽  
Priyanka Sonawane ◽  
Umme Ammara Iqbal
Keyword(s):  
Pregnant Women ◽  
Neonatal Intensive Care ◽  
Severe Infection ◽  
Risk Groups ◽  
Current Data ◽  
Nasopharyngeal Swab ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Background: Since the first confirmed case in December 2019, the data pertaining to the COVID-19 pandemic has been rapidly evolving. In current study, the relation of COVID-19 and its effect on pregnant women with hypertensive disorders in pregnancy, including symptoms and foetomaternal outcome were studied.Methods: Women with hypertensive disorders in pregnancy consecutively admitted for delivery and tested via nasopharyngeal swab for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR) from 1 April 2020 to 30 September 2020 were included in the study.Results: In our study, 56 women having hypertensive disorders in pregnancy with COVID-19 infections delivering 60 babies (4 twins), 46.43% were in the age group of <25 years, 51.78 % were <37 weeks gestation. Delivery was by caesarean section in 76.78%. Out of these, 33.92% patients required ICU admission. 40% babies delivered had birth weight of <2.5 kg out of which 13.33% had IUGR and 26.66% were preterm. There was 13.33% stillbirth and 6.66% neonatal deaths. 4 maternal death has been reported.Conclusions: With the current data available it does not appear that pregnant women are at increased risk of severe infection than the general population, but clinicians should be aware of high-risk groups. Women will need to be monitored in their booking maternity units and should be transferred to centres with appropriate neonatal intensive care facilities for delivery. In pregnant women with COVID-19 infection, if maternal illness is not severe, the considerations should be based more on obstetric indications for delivery.

scholarly journals Incidence, risk factors and impact of seasonal influenza in pregnancy: A national cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244986
Author(s):  
Nicola Vousden ◽  
Kathryn Bunch ◽  
Marian Knight ◽  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Pregnant Women ◽  
Neonatal Intensive Care ◽  
Seasonal Influenza ◽  
Perinatal Outcomes ◽  
Severe Infection ◽  
Risk Groups ◽  
Increased Risk ◽  
In Pregnancy

Background Pregnant women are particularly vulnerable to severe infection from influenza resulting in poor neonatal outcomes. The majority of evidence relates to pandemic 2009 A/H1N1 influenza. The objective of this study was to describe the characteristics and outcomes of pregnant women hospitalised with seasonal influenza. Methods This national, prospective, observational cohort study used the UK Obstetric Surveillance System (UKOSS) to identify all pregnant women admitted to hospital between 01/11/2016 and 31/10/2018 with laboratory confirmed influenza at any gestation and up to two days after giving birth. These were compared to women admitted to give birth that did not have influenza. Baseline characteristics, immunization status, maternal and perinatal outcomes were compared. Results There were 405 women admitted to hospital with laboratory confirmed influenza in pregnancy: 2.7 per 10,000 maternities. Compared to 694 comparison women, women with influenza were less likely to be professionally employed (aOR 0.59, 95%CI 0.39–0.89) or immunised in the relevant season (aOR 0·59, 0·39–0·89) and more likely to have asthma (aOR 2.42, 1.30–4.49) or have had a previous pregnancy complication (aOR 2·47, 1·33–4·61). They were more likely to be admitted to intensive care (aOR 21.3, 2.78–163.1) and to have a cesarean birth (aOR 1·42, 1·02–1.98). Their babies were more likely to be admitted to neonatal intensive care (aOR 1.86, 1·01–3·42). Conclusions Immunization reduces the risk of hospitalisation with influenza in pregnancy which is associated with increased risk of morbidity for both the mother and baby. There is a continued need to increase awareness of safety and effectiveness of immunization in pregnancy and provision within antenatal care settings, especially for high-risk groups.

scholarly journals Incidence, risk factors and impact of seasonal influenza in pregnancy: A national cohort study

2020 ◽  
Author(s):  
Nicola Vousden ◽  
Kathryn Bunch ◽  
Marian Knight ◽  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Pregnant Women ◽  
Neonatal Intensive Care ◽  
Seasonal Influenza ◽  
Perinatal Outcomes ◽  
Severe Infection ◽  
Risk Groups ◽  
Increased Risk ◽  
In Pregnancy

Background Pregnant women are particularly vulnerable to severe infection from influenza resulting in poor neonatal outcomes. The majority of evidence relates to pandemic 2009 A/H1N1 influenza. The objective of this study was to describe the characteristics and outcomes of pregnant women hospitalised with seasonal influenza. Methods This national, prospective, observational cohort study used the UK Obstetric Surveillance System (UKOSS) to identify all pregnant women admitted to hospital between 01/11/2016 and 31/10/2018 with laboratory confirmed influenza together with a comparison group of pregnant women. Baseline characteristics, immunisation status, maternal and perinatal outcomes were compared. Results There were 405 women admitted to hospital with laboratory confirmed influenza in pregnancy: 2.7 per 10,000 maternities. Compared to 694 comparison women, women with influenza were less likely to be professionally employed (aOR 0.59, 95%CI 0.39-0.89) or immunised in the relevant season (aOR 0.59, 0.39-0.89) and more likely to have asthma (aOR 2.42, 1.30-4.49) or have had a previous pregnancy complication (aOR 2.47, 1.33-4.61). They were more likely to be admitted to intensive care (aOR 21.3, 2.78-163.1) and to have a caesarean birth (aOR 1.42, 1.02-1.98). Their babies were more likely to be admitted to neonatal intensive care (aOR 1.86, 1.01-3.42). Conclusions Immunisation reduces the risk of hospitalisation with influenza in pregnancy which is associated with increased risk of morbidity for both the mother and baby. There is a continued need to increase awareness of safety and effectiveness of immunisation in pregnancy and provision within antenatal care settings, especially for high risk groups.

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 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 Perinatal outcome in hypertensive disorder of pregnancy in a rural community of Haryana

2019 ◽  
Vol 6 (10) ◽  
pp. 4267
Author(s):  
Bharti . ◽  
Sumit Chawla
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Statistical Tests ◽  
Mode Of Delivery ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
In Pregnancy

Background: Pregnancy in hypertension may complicate pregnancies with variable incidence among different settings. Pregnancies complicated with hypertensive disorders are associated with increased risk of adverse fetal, neonatal and maternal outcome including preterm birth, intrauterine growth retardation (IUGR), perinatal death etc. The present study was undertaken to study the perinatal outcome of hypertension in pregnancy in a rural block of Haryana.Methods: This cross-sectional study was carried out in the all the 20 subcenters under Community Health Center (CHC) Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Pregnancy outcome was followed-up by contacting the health worker of respective sub-center or mother. Information regarding stillbirth, abortion, maturity, birth weight, mode of delivery and early neonatal death was collected. Appropriate statistical tests were used for analysis.Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Hypertension in pregnancy is significantly associated with premature births still births (6.7% vs 1.4%; p=0.003), low birth weight (26.7% vs 4.9%; p=0.000) and early neonatal deaths (8.3% vs 2.8%; p=0.017).Conclusions: Perinatal mortality is significantly high in mothers with hypertensive disorders. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.

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 Management of pregnancy-related hypertensive disorders in patients infected with SARS CoV-2: pharmacological and clinical issues

2020 ◽  
Author(s):  
Silvia Fogacci ◽  
Federica Fogacci ◽  
Elda Favari ◽  
Peter P Toth ◽  
Claudio Borghi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Antihypertensive Drugs ◽  
Relevant Literature ◽  
Chronic Respiratory Disease ◽  
Antihypertensive Medications ◽  
Pharmacological Interaction ◽  
Hypertensive Disorders ◽  
The World ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Abstract Coronavirus-19 disease (COVID-19) continues to spread throughout the world. It is known that among patients with hypertension, diabetes, chronic respiratory disease, or cardiovascular diseases, COVID-19 is associated with greater morbidity and mortality compared with patients without these conditions. This correlation is of great importance in pregnant women affected by COVID-19, since it usually leads to the development of a serious clinical complication. In particular, managing hypertensive disorders in pregnancy can be problematic because antihypertensive medications may interact pharmacologically with drugs used to treat COVID-19. This review focuses on the safety of drug treatment for COVID-19 in pregnant women treated with antihypertensive medication. Several databases were searched to identify relevant literature. A few antihypertensive drugs and antithrombotic treatments are known for having a beneficial effect in the management of hypertension and hypertensive disorders in pregnancy. In this review, we focus on the expected drug–drug interactions with the experimental agents most often used to treat COVID-19. The current indications for the management of hypertension-related disorders in pregnancy maintain their validity, while the risk of pharmacological interaction with the currently tested anti-SARS-CoV-2 medications is relatively low.

scholarly journals Pregnancy outcome in elderly primigravidae at a Nigerian Tertiary Hospital: a five-year review

2018 ◽  
Vol 7 (2) ◽  
pp. 391
Author(s):  
R. O. Opadiran ◽  
A. D. Isah ◽  
N. Adewole ◽  
K. I. Omonua
Keyword(s):  
Pregnancy Outcome ◽  
Maternal Age ◽  
Caesarean Delivery ◽  
Neonatal Outcome ◽  
Statistical Significance ◽  
The Elderly ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Background: Pregnancy though a physiologic process also comes with its complications. This has been found to be related to factors associated with the mother and fetus. Maternal age at first pregnancy is a determining factor which could affect pregnancy outcome. Objective of present study was to determine the effect of maternal age on obstetric outcome.Methods: A five-year retrospective case control study involving primigravid women aged 35years and above (elderly primigravidae) and the younger primigravidae aged below 35 years who delivered at the University of Abuja Teaching hospital (UATH) between 2012 and 2016. Data were collected from their case notes, antenatal and delivery registers. For comparative purposes, obstetric and perinatal parameters including antenatal, labour, delivery, postpartum factors were collected for both the elderly primigravidae and younger primigravidae. A total of 6,052 deliveries, of which 2,456 were primigravidae and 42 of them were ≥35years of age. Out of 42 cases, only 30 folders were found and analyzed. The matched controls were selected consecutively after each elderly primigravidae in the register without prior knowledge of their pregnancy outcome. The data was analyzed using SPSS version 20. Chi square test X2 and student T test were used for comparison of the two groups. Statistical significance was set at P values of ≤ 0.05 at 95% confidence interval.Results: The incidence of elderly primigravidae was found to be 1.2% in this study. There was increased risk of hypertensive disorders in pregnancy, caesarean delivery and low APGAR scores in the elderly primigravidae group but these were not statistically significant. No other differences in obstetrics and neonatal outcome were found between the two groups.Conclusions: Elderly primigravidae are at increased risk of hypertensive disorders in pregnancy and caesarean delivery than in younger primigravidae. On the other hand, neonatal outcome of the two groups were comparable. 

scholarly journals Clinical and haematological features of newborns of mothers with hypertensive disorders in pregnancy in Lagos, Nigeria

2020 ◽  
Vol 47 (3) ◽  
pp. 252-257
Author(s):  
O.S. Omoniyi ◽  
I.B. Fajolu ◽  
A. Adediran ◽  
E.O. Temiye ◽  
J.I. Ladele
Keyword(s):  
Birth Weight ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Pregnancy Hypertension ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
Key Words Newborn ◽  
Haematological Indices ◽  
In Pregnancy

Background: Newborns of mothers with hypertensive disorders in pregnancy have an increased risk of preterm delivery, low birth weight, perinatalasphyxia and haematological derangements such as polycythaemia, thrombocytopenia and neutropenia. These morbidities are associated with  uteroplacental insufficiency. The haematological derangements however have not been studied in detail in African neonates. Objective: To determine the clinical and haematological features of newborns of hypertensive mothers Methods: Cross-sectional study involving 250 newborns; 125 newborns each of hypertensive mothers (cases), and normotensive mothers (controls). The babies were examined following delivery, their clinical data were recorded, and umbilical cord blood samples were analysed for haematological indices. Results: Preterm deliveries were significantly higher amongst infants of hypertensive mothers (31.2%)compared with controls (12.0%);p = 0.000.  Similarly, the birth weight, length and head circumference of the cases were significantly lower than the controls; p = 0.008, 0.003 and 0.004 respectively. Low fifth minute APGAR scores occurred more frequently in cases (8.0%) than controls (0.8%), p=0.010; whilst the mean haematocrit  was also significantly higher in cases than the controls, p = 0.013. The median absolute neutrophil count and platelet count were significantly lower in cases than controls; p=0.023 and 0.047 respectively. Thrombocytopenia was identified in 40.0% of the cases compared to 27.2% of the controls, p =  0.041 Conclusion: The present study has shown that newborns of hypertensive mothers have an increased risk of neonatal morbidities such as preterm birth, LBW and thrombocytopenia compared to the newborns of mothers with normal blood pressure in pregnancy, hence close attention needs to be paid to them with emphasis on their haematological system. Key words: newborn, pregnancy, hypertension, hypertensive disorders, haematological, clinical 

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