scholarly journals Perinatal Findings in Pregnancy Induced Hypertension: A Study in a Tertiary Teaching Hospital in Dhaka City

2017 ◽  
Vol 2 (1) ◽  
pp. 10-13
Author(s):  
Zobaida Sultana Susan ◽  
Surayea Bulbul ◽  
Jannat Ara Ferdows ◽  
Abu Nayeem

Background: Hypertensive disorders are common complication occurring during pregnancy which are responsible for maternal and fetal mortality and morbidity. Objective: The purpose of the present study was to determine the perinatal outcome in pregnancy induced hypertension. Methodology: This study was designed as cross-sectional study and was conducted from April 2013 to September 2013 for a period of six (06) moths. Patients admitted in the Department of Obstetrics and Gynaecology at Shaheed SuhrawardyMedical College Hospital, Dhaka. Data were collected by interview, physical examintions (blood pressure, pulse rate, oedema, heart and lungs auscultation) and lab investigations using a structural questionnaire. Result: Majority of the women belonged to age group 21-25 year. Maximum were (56%) primigravida. The mean gestational age was 34.6 weeks with the range from 28 to 40 weeks. Hyperurecaemia was frequent among patients with pregnancy induced hypertension. Intrauterine growth retardation (IUGR) was secondary to pregnancy induced hypertension which was associated with significantly increased perinatalmortality. Conclusion: In this study, prematurity is frequent in pregnancy induced hypertension and convulsion in nonresponsive patients is associated with significantly increased perinatal mortality.Journal of National Institute of Neurosciences Bangladesh, January 2016;2(1): 10-13

Author(s):  
Hemalatha S. ◽  
S. M. Shaheedha ◽  
Ramakrishna Borra

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [<20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in <20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.


2005 ◽  
Vol 94 (11) ◽  
pp. 1071-1076 ◽  
Author(s):  
Sunil Nadar ◽  
Ioannis Karalis ◽  
Eman Al Yemeni ◽  
Andrew Blann ◽  
Gregory Lip

SummaryThis study tests the hypothesis that abnormalities in plasma indices of angiogenesis, such as Vascular Endothelial Growth Factor (VEGF) and angiopoietins (Ang-1, Ang-2), as well as their soluble receptors Flt-1 (sflt-1) and Tie 2 (sTie-2) respectively, are present in women with in pregnancy-induced hypertension (PIH). We also measured platelet levels of VEGF and Ang-1 (pVEGF and pAng-1 respectively). We studied 69 consecutive women with PIH (34 without proteinuria, and 35 with proteinuria, i.e. preeclampsia) who were compared to 64 consecutive women with normotensive pregnancies and 30 normotensive non-pregnant women, in a cross-sectional study. Using ELISA, we measured levels of plasma VEGF, Ang-1 &2, Tie-2 and sflt-1, and also the levels of angiogenic markers within the platelet [platelet VEGF (pVEGF) and platelet Ang-1 (pAng1)] by lysing a fixed number of platelets with 0.5% tween. Results show that levels of plasma VEGF, Ang-1, Ang2, sFlt-1 and Tie-2 were significantly different between the study groups. Post hoc analyses revealed plasma Ang-1 was highest in the preeclampsia group (p<0.001), whilst Ang-2 was highest in the normotensive pregnant group (p-=0.018). Plasma Tie-2 was highest in the PIH group. VEGF levels were significantly different between the preeclampsia group and the PIH group (p<0.05). Platelet VEGF levels were higher in the non-pregnant group than in the pregnant group, but there were no significant differences in the platelet levels of Ang-1 between the different groups. Ang-2, sFlt-1 and Tie-2 were undetectable in the platelet lysate in any of the patient groups or controls. Blood pressure was a major determinant of the different angiogenic factors studied. Abnormal indices of angiogenesis are evident in PIH and preeclampsia, with higher levels of sFlt-1 and lower levels ofVEGF; in PIH, increased levels of Ang-1 and Tie-2, but reduced Ang-2, are evident compared to normal pregnancy. These abnormalities may have implications for the pathogenesis of PIH and preeclampsia.


2018 ◽  
Vol 17 (1) ◽  
pp. 29-33
Author(s):  
Kazi Farhana Noor ◽  
Farida Yasmin ◽  
Rupasree Biswas ◽  
Moumita Tripura Mumu ◽  
Uma Dev

Background: Ruptured uterus is an obstetric emergency, carrying increased risk of maternal and perinatal mortality and morbidity especially in the developing countries. To determine the various aspects such as antecedent factors, clinical profile, management, outcome of ruptured uterus in a tertiary hospital. Methods: This prospective cross-sectional study conducted in the Department of Obstetrics and Gynecology in Chittagong Medical College Hospital, Chittagong, from January 2010 to December 2010. 70 consecutive admitted patients during this period was taken in this study. Results: During study period total 13635 obstetric patients were admitted and among them 70 cases were of ruptured uterus which gives an incidence of 0.5%. 92.85% of the women were multiparous. 77% patient did not have any antenatal care. 81% were illiterate and 82% belong to low socio-economic class. Common risk factors were mal-handling of labor by untrained dai (44%) cephalopelvic disproportion (35%) previous caesarean scar (34.28%) shoulder presentation 15%, abused of oxytocic drug (14%). Shock and sepsis were the prominent presenting features. In most cases, the tear was in the lower segment and in 54 patients (80%) the tear was complete. 25 (37%) patients had sub-total hysterectomy, 22 had repair and 13 (19.4%) had total hysterectomy. Maternal and fetal mortality rate was 11.42% and 88.5% respectively. Conclusion: A high incidence (1 in 195) of ruptured uterus mainly because of inadequate natal and intranatal care, high parity, mismanagement of labor, Low socio-economic condition and illiteracy. Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 29-33


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Tsegaye Mehare ◽  
Daniel Kebede

Introduction. Placenta is a complex multifunctional organ that maintains pregnancy and promotes normal fetal development. The fetal outcome is adversely influenced by pathological changes in the placenta because it is a mirror that reflects the intrauterine status of the fetus. Placental abnormalities are considered a leading cause of maternal and prenatal mortality. This study aimed to assess the fetoplacental weight relationship in pregnancy-induced hypertension and abruption placenta and compare with the normal one. Objective. This study designed to assess fetoplacental weight relationships in normal pregnancy and pregnancy complicated by pregnancy-induced hypertension and abruption of placenta among mothers who gave birth in Dilla University Referral Hospital, southern Ethiopia, 2018. Materials and Methods. Institution-based comparative cross-sectional study was used on 50 placentas from mothers with pregnancy-induced hypertension, 50 placentas from mothers with abruption of placenta, and 50 placentas from mothers with normal pregnancy (control) with an age range of 19–34 years. The weight of the placenta and newborn were taken and the fetoplacental ratio was calculated. Results. Placental index as well as the weight of the newborn shows statistically significant (p<0.001) difference in pregnancy-induced hypertension and abruption placenta group compared with the normal group. The mean of the fetoplacental ratio in the normal group was 5.52 ± 0.07, in pregnancy-induced hypertension was 5.15 ± 0.11, whereas the abruption placenta was 4.99 ± 0.82. Conclusion. Both PIH and abruption placenta were associated with remarkable changes in the placenta index such as small placental weight and diameter and results in different kinds of congenital anomalies and low birth weight of the baby. Hence, fetoplacental ratio was altered. The lowest fetoplacental ratio was 4.99 for abruption placenta, and the highest was for a normal group of the placenta which was 5.52. Therefore, an examination of the placenta before and after birth guarantees for feto-maternal health.


2021 ◽  
Vol 15 (12) ◽  
pp. 3307-3309
Author(s):  
Samia Saifullah ◽  
Maryam Shoaib ◽  
Muhammad Sohail Tareen ◽  
Nosheen Sikander Baloch

Background: Pregnancy induced hypertension is a fetal disease resulting into morbidity and mortality of female as well as its neonate. Objective: To find the incidence of pregnancy induced hypertension in Pakistani women. Study Design: Cross sectional study Place and Duration of the Study: Department of Obstetrics & Gynaecology, Sandeman Provincial Hospital, Quetta from 1st March 2019 to 31st March 2021. Methodology: Seven hundred and twenty eight females were identified with pregnancy induced hypertension from all the pregnant women attending the outdoor were enrolled. Each female was checked for their protein urea as well as systolic and diastolic blood pressure according to standard operating protocol. Socio-demographic, clinical and family history were documented. Results: Among all pregnant women, 150 were identified as pregnancy induced hypertensive with a 20.6% incidence of pregnancy induced hypertension. The mean value systolic blood pressure value was 144.3±5.2 and of diastolic as 83.1±5.2 in pregnancy induced hypertension women. Conclusion: Family history, obesity and renal diseases are the main factors associated with pregnancy induced hypertension with an incidence of 20.6% among pregnant women. Keywords: Pregnancy induced hypertension, Body mass index, Pregnant women, Hypertension


Author(s):  
Rihab A. Yousif ◽  
Awadia G. Suliman ◽  
Raga A. Aburaida ◽  
Ibrahim M. Daoud ◽  
Naglaa E. Mohammed

The pregnancy induced hypertension increase the fetal mortality and morbidity and the using of Doppler umbilical artery indices decrease the fetal mortality and morbidity however, there is few complete data about the most frequently altered Doppler US parameters to predict fetal outcome in pregnancy induced hypertension . Methods This ia cohort prospective study done in two hundred and six women of second and third trimester presenting to antenatal clinic in Soba University Hospital at the department of Obstetrics & Gynecology, in the fetus unit and critical pregnancy in the period From June 2008 to April 2013 to assess the Doppler indices of umbilical artery in pregnancy induced hypertension for prediction of prenatal outcome; 105 pregnancy induced hypertension patients and 101 women with uneventful pregnancies as normal control group included in this study . Baseline investigations and color Doppler of umbilical artery were done. Statistical analysis of data were done using SPSS, Receiver Operating Characteristic (ROC) curve analysis was performed and the area under the curve (AUC) used to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of umbilical artery Doppler indices to predict fetal outcome.Results The study determine that there was significant difference in Doppler indices in PIH and control group ( p<0.01, the mean indices of umbilical artery is higher in PIH group compared with normal pregnancy group , the mean different of S/D ratio was 0.40, mean difference of RI was 0.06 and the mean different of PI index was 0.16, high percentage of adverse fetal outcome had been reported in in Pregnancy Induced Hypertension group than in control , which was more in absent and reversed flow velocity in umbilical artery in Pregnancy Induced Hypertension compared with group of Pregnancy Induced Hypertension with present end diastolic flow velocity. Systolic/Diastolic ratio was most accurate in predicting adverse outcome in pregnancy induced hypertension patients, followed by the Pulastility index then the Resistance index (75%, 66% and 57% respectively).ConclusionThis study concluded that pregnancy induced hypertension leads to worsen placental insufficiently, which appears on the higher Doppler indices of umbilical artery to PIH patients when compared with normal pregnancy. A low diastolic flow and higher indices characterized the pregnancies with abnormal outcomes. Doppler of the umbilical artery was useful to predict fetal well being in PIH patients, high percentage of adverse fetal outcome had been reported in absent and reversed end diastolic flow velocity in umbilical artery compared with group of present flow velocity.


Author(s):  
Akramsadat Dehghani Firoozabadi ◽  
Razieh Dehghani Firouzabadi ◽  
Maryam Eftekhar ◽  
Afsar Sadat Tabatabaei Bafghi ◽  
Farimah Shamsi

Background: Pregnancy is a process associated with various metabolic and hormonal changes, and polycystic ovary syndrome (PCOS) can affect this process. Objective: This study aimed to evaluate and compare the maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes. Materials and Methods: In this cross-sectional study, 200 pregnant women with PCOS according to the 2003 ESHRE/ASRM criteria were categorized into four phenotype groups (A-D). The maternal outcomes include gestational diabetes mellitus, pregnancy-induced hypertension, premature rupture of membranes, preterm labor, small-for-gestational age birth, intrauterine growth restriction, intrauterine mortality, preeclampsia, abortion, amniotic fluid disorders, delivery method, and cause of cesarean section were studied between groups. Additionally, neonatal outcomes such as neonatal weight, neonatal recovery, 5-min Apgar score, neonatal icter, the need for NICU admission, the cause of hospitalization, and infant mortality rate were investigated and compared among the groups. Results: According to the results, phenotype D (37%) was the most common phenotype among the participants. The risk of gestational diabetes was more common in phenotype A than in the other phenotypes, whereas pregnancy-induced hypertension was most common in phenotype B. No significant differences were observed in the neonatal complications among the PCOS phenotypes. Conclusion: Considering the higher risk of gestational diabetes mellitus and pregnancy-induced hypertension in PCOS phenotypes A and B, women with these phenotypes need more precise prenatal care. Key words: Pregnancy outcome, Polycystic ovary syndrome, Phenotype, Pregnancy.


2021 ◽  
Vol 15 (1) ◽  
pp. 69-72
Author(s):  
Sadia Kadir ◽  

Background: Grand multiparity considered as a risk factor of obstetrics because of the recorded complications linked to the condition. Grand multiparity typically considered as the distinctive reason for the raised, maternal and fetal morbidity and mortality because of expanded incidence of adverse outcome during pregnancy and birth. Objective: To determine frequency of antenatal complications in grand multipara. Study Design: Cross-sectional study. Settings: Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre, Karachi Pakistan. Duration: Study duration was six months from March 2016 September 2016. Methodology: Total 212 patients were included in this study. Anemia was taken as Hb of 11g/dl, PIH was taken as BP of >140/90mmHg after 20 weeks of gestation with or without proteinuria on two or more occasion 6 hours apart and placenta previa was confirmed via ultrasonography. All the information was collected via study proforma. Results: Patients mean age was 34.90±3.51 years. Most of the patients 96.7% had parity 5-9. Anemia was found 69.8% and pregnancy induced hypertension was 22.2%, while placenta previa was found to be 18.9%. Antenatal complications including anemia, pregnancy induced hypertension and placenta previa were found to be statistically insignificant according to age, parity and BMI, (p->0.05). Conclusion: Most common antenatal complication in this study was anemia followed by hypertension and placenta previa. Grand multiparity is at a greater risk of antenatal complications.


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