Neurodevelopment and growth outcome at one year in babies born at term to mothers having pregnancy induced hypertension

Background: Hypertensive disorder in pregnancy remains an important cause of perinatal morbidity and mortality. Being small for gestational age (SGA) may be associated with poor neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper is to evaluate neurodevelopmental scores as well as growth monitoring in SGA and AGA infants born at term to PIH mothers followed till one year of age.Methods: This is a prospective, observational, hospital-based study, conducted in a tertiary care mother and child institute in Andhra Pradesh, South India.Results: Two hundred babies born at term to PIH mothers are included in the study and are followed up over a period of 12 months. Data is analyzed using Statistical Package for Social Sciences (SPSS). Growth retardation is seen in 12 % of term, SGA and 3.5% of term, AGA babies. SGA babies have a statistically significant correlation (p value = 0.02) in physical growth compared to AGA babies. Neurodevelopmental delay is present in 30% of SGA babies and 5% of AGA babies. The association between SGA and neurodevelopmental disability is statistically significant (p value <0.01).Conclusions: Pregnancy induced hypertension has a statistically significant effect on neurodevelopment and physical growth of a child when followed up to 12 months of age, in SGA babies, more so in VLBW babies. Early intervention programmes through medical, developmental, neuromotor, neurosensory interventions and other stimulation programs, might help in reducing the burden of the disease as well as improving the quality of life.

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The association of pregnancy-induced hypertension and neonatal hypospadias.

10.22541/au.161248631.13273255/v1 ◽

2021 ◽

Author(s):

Yi Wang ◽

Lin Wang ◽

Zeyong Yang ◽

Fang Chen ◽

Zhiwei Liu

Keyword(s):

Regression Analysis ◽

Birth Weight ◽

Gestational Age ◽

Occurrence Rate ◽

Multiple Birth ◽

Control Group ◽

Hypertensive Disorder ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

In Pregnancy

Background: The prevalence of hypertensive disorder in pregnancy has been well-documented worldwide. In Chinese newborns, the risk of hypospadias in women with hypertension during pregnancy remains ambiguous. This study aimed to evaluate the relationship between hypertension in pregnancy and neonatal hypospadias based on a large sample of Chinese people. Methods: A retrospective cohort study was conducted at our hospital from 2015 to 2019. Mothers who delivered male infants with hypospadias or those without any malformations were enrolled. Factors such as hypertension, placenta previa, thyroid diseases, hepatitis B, obesity, multiple birth, amniotic fluid, gestational age, birth weight, and in vitro fertilization were collected to establish a regression analysis to assess risk factors for hypospadias. Results: In total, 41,490 mothers and 42,244 male infants were enrolled. The overall incidence of hypospadias was 0.23%. The occurrence rate of hypospadias in pregnancy-induced hypertension (PIH) group was higher than control group (0.944% vs. 0.186%, RR 5.08), whereas the occurrence rate in chronic hypertension group was 0%. Potential exposure factors were screened for hypospadias, and PIH, multiple birth, hyperthyroidism, preterm delivery, low birth weight, and small for gestational age (SGA) were found to have higher proportion of hypospadias in offspring. After adjustment for potential confounders in the multivariate regression analysis, PIH (OR: 2.437, 95% CI: 1.478–4.016, P<0.01), birth weight (OR: 0.852, 95% CI: 0.795–0.912, P<0.01), and SGA (OR: 3.282, 95% CI: 1.644–6.549, P<0.01) showed a significant relationship with hypospadias. Conclusion: Women with PIH had higher risks of hypospadias in offspring. Lower birth weight, SGA and hyperthyroidism were also statistically associated with hypospadias.

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Prevalence of Pregnancy-Induced Hypertension and Its High-Risk Factors among the Antenatal Women

Journal of Health and Allied Sciences NU ◽

10.1055/s-0041-1726687 ◽

2021 ◽

Author(s):

Sony John ◽

M. Vanitha ◽

Athira Babu ◽

Priya Sushma ◽

Ashihrii Eloni Regina ◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Tertiary Care ◽

Previous History ◽

Total Sample ◽

Hypertensive Disorder ◽

Care Hospital ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

History Of

Abstract Objective A hypertensive disorder during pregnancy seriously endangers the safety of the fetus and women during pregnancy. This study was conducted to estimate the prevalence of pregnancy-induced hypertension (PIH) and its risk factors among antenatal women. The aim of this study was to find the prevalence of PIH and risk factors for PIH among antenatal women in a selected hospital in Mangaluru. Methods A descriptive study was performed. The study used the total sample size of 400 pregnant women attending the obstetrics and gynecology outpatient department according to the inclusion and exclusion criteria in a tertiary care hospital in Karnataka. The data was collected with a self-reported checklist. Data were entered and analyzed by using SPSS 23. Results The prevalence of PIH was 10.75% that is 43 antenatal women out of 400. In this study, 34.88% had a family history of PIH, 23% had a previous history of PIH, 16% had a history of gestational diabetes, and 20.93% had a history of thyroid problems. The most important risk factors found for PIH in the present study are the previous history of PIH (adjusted odds ratio [OR] = 1.276, 95% confidence interval [CI: 0.125–11.836), family history of hypertension (adjusted OR=1.930, 95% CI: 1.130–3.296), and thyroid problems (adjusted OR=1.904, CI: 0.786–4.611). Conclusion PIH is a common medical disorder associated with pregnancy. We noted that PIH is more prevalent in those who had it in their previous pregnancy. PIH is associated with multiple complications in the mother and the baby and particularly preterm delivery. The timely intervention of regular antenatal checkups, nutrition, health education, etc., can reduce the severity of PIH.

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INDUCTION OF LABOUR;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.04.1530 ◽

2017 ◽

Vol 24 (04) ◽

pp. 522-525

Author(s):

Nadia Taj ◽

Rahat Akhtar ◽

Sumera Mehnaz ◽

Aamir Furqan

Keyword(s):

Caesarean Section ◽

Gestational Age ◽

Expectant Management ◽

Induction Of Labour ◽

P Value ◽

Pregnancy Induced Hypertension ◽

Induction Group ◽

Induced Hypertension ◽

Group A ◽

Group B

Objectives: To compare maternal outcome in planned induction of laborversus expectant management in pregnancy induced hypertension between 36 to 40 weeks ofgestation. Study Design: Randomized controlled trial. Setting: Obstetrics and Gynecology UnitII of Nishter Hospital Multan. Period: January 2016 to July 2016. Materials and Methods: Onehundred and thirty six (136) women with diagnosis of mild pregnancy induced hypertension,having gestational age 36 to 40 weeks were selected for this study. The selected patients wereallocated randomly into two equal groups i.e. Group A (Induction group) & Group B (Expectantgroup). The primary outcomes of this study were rate of cesarean section delivery anddevelopment of severe pre-eclampsia. Independent sample t-test was used to compare agebetween the groups. Chi-square test was used to compare age groups and study endpointsbetween the groups. Results: Mean gestational age at the time of delivery was 38.3 ± 0.75weeks for group A and 39.2 ± 0.55 weeks for group B (P-value >0.05). Mode of delivery was 52(76.47%) patients by vaginal and 16 (23.53%) by caesarean section in group A. While in groupB, out of 68 deliveries, 40 (58.82%) patients delivered by vaginal and 28 (41.18%) by caesareansection (p-value <0.05). Regarding maternal outcomes, severe pre-eclampsia occurred in 05(7.35%) women of group A while in group B, it was noted 15 (22.05%) women (p-value<0.05).The final outcome was considered satisfactory in 76.47% patients in Induction group regardingvaginal delivery and severe pre-eclampsia while in Expectant group satisfactory outcomes wereachieved in only 23.53% women (p-value <0.05). Conclusion: Induction of labour is associatedwith improved maternal outcome in terms of caesarean section and pre-eclampsia in womenwith mild PIH beyond 36 weeks of gestation as compared to the expectant management.

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Neonatal Outcome of Macrosomia

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v40i2.28917 ◽

2020 ◽

Vol 40 (2) ◽

pp. 114-119

Author(s):

Subhash Chandra Shah ◽

Anusmriti Guragain ◽

Shreejana Pandey ◽

Ajaya Kumar Dhakal

Keyword(s):

Maternal Age ◽

Neonatal Outcome ◽

Tertiary Care ◽

Public Health Problem ◽

Pregnancy Induced Hypertension ◽

Factors Associated ◽

Adverse Neonatal Outcome ◽

Induced Hypertension ◽

Appropriate For Gestational Age ◽

Prolonged Hospital

Introduction: Macrosomia is an emerging public health problem, both in the developed as well as in the developing countries. This study was aimed to examine the maternal and neonatal risk factors associated with macrosomia and compare adverse neonatal outcome between appropriate for gestational age (AGA) and macrosomia. Methods: Records of all live singleton AGA and macrosomic babies delivered at a tertiary care teaching hospital in Lalitpur, Nepal, between 14th April 2013 and 13th April 2014 were retrospectively reviewed. Results: Of the 769 deliveries, 684 neonates were eligible of which 93 were born macrosomic with an incidence of 12.1%. We observed the most significant neonatal outcome to be neonatal sepsis (14%; p = 0.005) compared to AGA babies (5.9%). Macrosomia was found to be associated with increasing maternal age and parity (p = 0.007) relative to mothers of AGA babies, most of whom underwent caesarean section (55.9%) whilst the same outcome was fewer for mothers of AGA babies (29.9%). A higher incidence of pregnancy induced hypertension (PIH) as maternal comorbidity (5.4%) was associated with macrosomia contrasted with mothers of AGA babies (4.4%). Conclusion: Macrosomic birth was found to be associated with relatively higher adverse neonatal outcome, warranting prolonged hospital admission than AGA births.

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Clinical Audit of Obstetrical Hysterectomies for a Period of One Year in A Tertiary Care Hospital

Esculapio ◽

10.51273/esc20.2516411 ◽

2021 ◽

Vol 16 (4 (oct 2020 - dec 2020)) ◽

Author(s):

Farzana Latif ◽

Sadia Ilyas ◽

Saeed Mehmood ◽

Hammad Arif ◽

Nuzhat Parveen Khawaja ◽

...

Keyword(s):

Gestational Age ◽

Tertiary Care Hospital ◽

Clinical Audit ◽

Tertiary Care ◽

Care Hospital ◽

Hospital Record ◽

Record System ◽

Peripartum Hysterectomy ◽

Emergency Peripartum Hysterectomy ◽

One Year

Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus. Key Words: Uterine artery embolization, Emergency peripartum hysterectomy, maternal morbidity and mortality, healthcare providers How to Cite: Latif F, Ilyas S, Mehmood S. Arif H. Khawaja P. Nuzhat. Jawad Z. J Clinical audit of obstetrical hysterectomies for a period of one year in a tertiary care hospital. Esculapio.2020;16(04):50-53.

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EPIDEMIOLOGICAL AND ETIOLOGICAL PROFILE OF IUFD: A PROSPECTIVE STUDY AT TERTIARY CARE CENTRE

10.36106/ijsr/6715560 ◽

2021 ◽

pp. 31-34

Author(s):

Deepali Jain ◽

Uma Jain ◽

Japhia David

Keyword(s):

Gestational Age ◽

Fetal Death ◽

Health Centre ◽

Tertiary Care ◽

Mode Of Delivery ◽

National Level ◽

Health Indicators ◽

Fetal Mortality ◽

Hypertensive Disorder ◽

Tertiary Care Centre

Introduction:- IUFD occurrence without warning in a previously normal pregnancy is really a challenge to obstetrician and distressing situation for parents. It becomes crucial to identify specic probable cause of fetal death, to prevent the re-occurance and get the corrective measures. Prenatal mortality is still of one of the top most health indicators in measuring the quality and impact of health services in developing countries Still birth is a useful index to measure the values of antenatal and intranatal care. To decrease the fetal mortality rate, evaluation, documentation and audit of the etiology and the associated risk factors for stillbirth is required. Material and method :- The present study aims at studying the various causes related to IUFD. Prospective observational study conducted on 112 patients at Department of Obstetrics and Gynaecology, Kamla Raja Hospital, G.R. Medical College and J.A. Group of Hospitals, Gwalior (M.P.) for 18 months. All those cases who were diagnosed as intrauterine dead fetus at the time of admission with gestational age >24 weeks pregnancy were included in the study. All those investigation available at the centre of mother and father were noted and details were taken. Epidemiological evaluation of causes of fetal death was done. Record of the method of induction and mode of delivery taken. RESULTS :-Total 112 cases found during the study period were included . We found maximum cases unbooked - 71.43%, which were mainly emergency admissions. Majority of the IUFD cases- 77.67% were found to lie in the age group of 20-30 yrs, most of them were primigravida 62.5%., maximum cases of IUFD were of the gestational age 31-35 weeks- 47.32%. Hypertensive disorder of pregnancy- 23.3 % cases were found to be the major associated cause followed by Antepartum Haemorrhage 11.5%, Severe anaemia 15.1%, diabetes- 14.2% jaundice - 9.8%. congenital anomaly- 9.8%. Oligohydromnios- 8.9% and IUGR were also found to be associated with IUFD, forming an indirect reason. 39.29% cases were unexplained. 86.6% cases delivered vaginally. 10.7% cases had to undergo LSCS and only 2.68% cases underwent laparotomy for rupture uterus. 11.61% cases were of macerated IUFD baby indicating long term neglected IUFD. 39.78% and 38.39% IUFD were of 2.0-2.5 kg and 1.5-2.0 kg. This show strong corelation with LBW and IUGR. CONCLUSION:- Unexplained cases, hypertensive disorder, anemia and diabetes were the major causes for IUFD. In spite of advances in diagnostic and therapeutic modalities a major cause of fetal death remain unexplained because of poverty, illiteracy, unawareness and inaccessibility of a health centre. Undoubtedly, continued surveillance of stillbirth rates is wanted for both high- and low-risk pregnancies at a state and national level.

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MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

10.36106/ijsr/3731386 ◽

2021 ◽

pp. 48-50

Author(s):

Neha Agarwal ◽

Samta Bali Rathore ◽

Shivani Baberwal-

Keyword(s):

Caesarean Section ◽

Perinatal Asphyxia ◽

Tertiary Care ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Care Hospital ◽

Pregnancy Induced Hypertension ◽

Meconium Aspiration ◽

Induced Hypertension

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.

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Effect of maternal high body mass index on outcome of pregnancy in women with recurrent miscarriages

Indian Journal of Forensic and Community Medicine ◽

10.18231/j.ijfcm.2021.048 ◽

2021 ◽

Vol 8 (4) ◽

pp. 237-241

Author(s):

Malangori Parande ◽

Tanvi V Wagh ◽

Anjali V Wagh ◽

Nandkumar Salunke

Keyword(s):

Gestational Diabetes ◽

Preterm Delivery ◽

Maternal Obesity ◽

Tertiary Care ◽

Overweight And Obesity ◽

Care Hospital ◽

Pregnancy Induced Hypertension ◽

Recurrent Miscarriages ◽

Induced Hypertension ◽

Maternal Overweight

The epidemic of obesity is spreading worldwide and subsequently, rate of obesity during pregnancy has also increased. Maternal overweight and obesity are widely associated with adverse pregnancy outcomes. Recurrent miscarriage is an important reproductive health issue, because it affects many couples. So the present study is planned to study the relationship between maternal obesity and pregnancy outcome in women with recurrent miscarriages. Observational Cross sectional study was conducted in a tertiary care hospital. 111 Postnatal women between 18 to 44 years of age with history of two or more miscarriages less than 20 weeks of gestation in previous pregnancy were included in the study. First trimester weight at the first visit (registration) was recorded, BMI was calculated & women were divided into obese and non obese groups. The outcome of present pregnancy was noted as Mode of delivery, Gestational diabetes mellitus, Pregnancy induced hypertension, Preterm delivery etc. Statistical tests were used to quantify the risk. Gestational diabetes (OR= 13.6) and pregnancy induced hypertension (OR=4.2) were significantly associated with obesity in women with recurrent miscarriages. [At 95% CI] The incidence of LSCS and preterm delivery was more in overweight and obese mothers, though not statistically significant. Maternal obesity significantly contributes to poor prognosis for the mother and the baby during delivery. Hence the women of this group should be regarded as ‘high risk’ and counselling and the risk assessment should be done during ANC visits.

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Comparison of the Antioxidant Nutrient Profile among Normal Pregnant Women and Women having Pregnancy Induced Hypertension

Pakistan Journal of Public Health ◽

10.32413/pjph.v10i4.388 ◽

2021 ◽

Vol 10 (4) ◽

pp. 246-251

Author(s):

Kausar Aamir ◽

Arfa Azhar ◽

Fatima Abid ◽

Shamaila Khalid ◽

Fiza Ali Khan

Keyword(s):

Vitamin E ◽

Pregnant Women ◽

Cell Damage ◽

Alpha Tocopherol ◽

Control Group ◽

P Value ◽

Pregnancy Induced Hypertension ◽

Nutrient Profile ◽

Induced Hypertension ◽

Mild Hypertensive

Background: Preeclampsia is a multifactorial disorder comprising many organs. Oxidative stress (OS) has been intensely linked to its occurrence. Vitamin E, a lipophilic chain breaking antioxidant has been proved to suppress the OS. Present study was designed to investigate antioxidant nutrient profile in patients with different grades of pregnancy induced hypertension (PIH) and to compare them with normal pregnant controls. Methods: The study group comprised 110 patients divided in three groups as Group A (n=40) Normotensive patients, Group B (n=40) Mild hypertensive, Group C (n=30) Severe hypertensive. Vitamin A, B-Carotene, serum alpha tocopherol (vitamin E) and vitamin C levels were analysed. Results: Serum alpha tocopherol (vitamin E) was significantly low in severe and mild cases (0.32±0.00 mg/dl, 0.74±0.03 mg/dl respectively), when compared with normal pregnant women levels (0.78±0.040). All other nutrients were also found to be in reduced quantity for Group C when compared to control group (P value <0.001). Conclusion: It was therefore concluded that in patients with risk of preeclampsia (PE) adequate antioxidant nutrients may have a role in cessation of free radical-mediated cell disturbances, and thereby protecting against endothelial cell damage, which is the key factor in PE development.

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Risk of small for gestational age babies in preterm delivery due to pregnancy-induced hypertension

Medical Journal of Indonesia ◽

10.13181/mji.v28i1.1795 ◽

2019 ◽

Vol 28 (1) ◽

pp. 57-62 ◽

Cited By ~ 1

Author(s):

Rima Irwinda ◽

Budi Iman Santoso ◽

Raymond Surya ◽

Lidia Firmiaty Nembo

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Preterm Births ◽

Secondary Data ◽

Large For Gestational Age ◽

Fisher Exact Test ◽

Pregnancy Induced Hypertension ◽

Exact Test ◽

Induced Hypertension ◽

The Impact

BACKGROUND Pregnancy-induced hypertension (PIH) causes high maternal morbidity and mortality worldwide. This study aims to assess the impact of PIH on fetal growth according to gestational age in preterm deliveries.METHODS A prospective cohort study using secondary data was undertaken in Ende District, East Nusa Tenggara, Indonesia from September 2014 to August 2015. The t-test was performed to compare mean birth weight based on gestational week between normotensive and PIH women, continued by linear regression. The chi-square or Fisher exact test was also conducted to determine the probability of birthing small for the gestational age (SGA) and large for gestational age (LGA) babies between normotensive and PIH women.RESULTS A total of 1,673 deliveries were recorded in Ende Hospital over the 1-year study period, among which 182 cases involved preterm births. The PIH group had lower birth weight than normotensive women at each gestational age starting from 32–35 weeks (p=0.004; 95% CI 150.84–771.36). Normotensive women at gestational ages of 32 (p=0.05; 95% CI 0.01–0.83), 34 (p=0.37; 95% CI 0.01–4.12), and 36 (p=0.31; 95% CI 0.02–2.95) weeks had a lower risk of birthing SGA babies than PIH women; LGA babies were recorded at gestational ages of 33 (p=1.00; 95% CI 0.07–37.73) and 35 (p=0.31; 95% CI 0.34–63.07) weeks.CONCLUSIONS Poor perfusion of the uteroplacental is one of the reasons behind intrauterine growth restriction, which results in SGA babies born to PIH women.

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