scholarly journals Luaran Ibu dan Perinatal pada Kehamilan dengan Preeklampsia Berat di RSUP Prof. Dr. R. D. Kandou Manado Periode 1 Januari - 31 Desember 2016

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Chaerul Kalam ◽  
Freddy W. Wagey ◽  
Suzanna P. Mongan
Keyword(s):  
Maternal Mortality ◽  
Visual Impairment ◽  
Perinatal Mortality ◽  
Hellp Syndrome ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Maternal Outcomes ◽  
Chronic Hypertension ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

Abstract: Maternal mortality in Indonesia is still dominated by three main causes: bleeding (30.3%), hypertension in pregnancy (27.1), and infection (7.3%). Hypertension in pregnancy is one of the main causes for maternal and perinatal mortality and morbidity. This tsudy was aimed to obtain maternal and perinatal outcomes in pregnancies with severe preeclampsia (sPE) at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2016. This was a descriptive retrospective study using patients’ medical record data. The results showed that the characteristics of pregnant woman with sPE included mother age 20-35 years old (69.2%), primigravida (50.8%), pregnancy interval ≥5 years (65.6%), preeclampsia history (25%), overweight (55.4%), and history of chronic hypertension (10.8%). The results of maternal outcomes included maternal mortality (1.5%), HELLP syndrome (4.6%), visual impairment (4.6%), eclampsia (6.2%), ICU care (1.5%), and sepsis (1.5%). The results of perinatal outcomes included perinatal mortality (4.6%), IUGR (6.2%), LBW (35.4%), asphyxia (7.7%), fetal distress (20%), and prematurity (26.2%). Conclusion: Maternal outcomes in pregnancy with sPE included mortality, HELLP syndrome, visual impairment, eclampsia, ICU care, sepsis meanwhile perinatal outcomes included perinatal mortality, IUGR, LBW, asphyxia, fetal distress, and prematurity.Keywords: sPE, maternal outcome, perinatal outcome Abstrak: Kematian ibu di Indonesia masih didominasi oleh tiga penyebab utama yaitu perdarahan (30,3%), hipertensi dalam kehamilan (27,1), dan infeksi (7,3%). Hipertensi dalam kehamilan merupakan salah satu penyebab utama mortalitas dan morbiditas pada maternal dan perinatal. Penelitian ini bertujuan untuk mengetahui luaran ibu dan perinatal pada kehamilan dengan preeklampsia berat (PEB) di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2016 - 31 Desember 2016. Jenis penelitian ialah retrospektif deskriptif menggunakan data rekam medik pasien PEB. Hasil penelitian pada kehamilan dengan PEB memperlihatkan karakteristik usia ibu 20-35 tahun (69,2%), primigravida (50,8%), jarak hamil ≥5 tahun (65,6%), riwayat preeklampsia (25%), overweight (55,4%), dan riwayat hipertensi kronis (10,8%). Luaran ibu meliputi mortalitas ibu (1,5%), sindrom HELLP (4,6%), gangguan penglihatan (4,6%), eklampsia (6,2%), rawat ICU (1,5%), dan sepsis (1,5%). Luaran perinatal meliputi mortalitas perinatal (4,6%), IUGR (6,2%), BBLR (35,4%), asfiksia (7,7%), gawat janin (20%) dan prematur (26,2%). Simpulan: Luaran ibu pada kehamilan dengan PEB berupa mortalitas, sindrom HELLP, gangguan penglihatan, eklampsia, rawat ICU, dan sepsis sedangkan luaran perinatal berupa mortalitas perinatal, IUGR, BBLR, asfiksia, gawat janin, dan prematur.Kata kunci: PEB, luaran ibu, luaran perinatal

Chronic hypertension in pregnancy: synthesis of influential guidelines

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ioannis Tsakiridis ◽  
Sonia Giouleka ◽  
Alexandra Arvanitaki ◽  
Apostolos Mamopoulos ◽  
George Giannakoulas ◽  
...  
Keyword(s):  
International Society ◽  
Perinatal Outcomes ◽  
Morbidity And Mortality ◽  
Chronic Hypertension ◽  
Optimal Dosage ◽  
Antenatal Corticosteroids ◽  
Hypertension In Pregnancy ◽  
Gynecology And Obstetrics ◽  
Obstetric Medicine ◽  
In Pregnancy

Abstract Chronic hypertension in pregnancy accounts for a substantial proportion of maternal morbidity and mortality and is associated with adverse perinatal outcomes, most of which can be mitigated by appropriate surveillance and management protocols. The aim of this study was to review and compare recommendations of published guidelines on this condition. Thus, a descriptive review of influential guidelines from the National Institute for Health and Care Excellence, the Society of Obstetric Medicine of Australia and New Zealand, the International Society of Hypertension, the International Society for the Study of Hypertension in Pregnancy, the European Society of Cardiology, the International Federation of Gynecology and Obstetrics, the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists on chronic hypertension in pregnancy was conducted. All guidelines agree on the definition and medical management, the need for more frequent antenatal care and fetal surveillance and the re-evaluation at 6–8 weeks postpartum. There is also a consensus that the administration of low-dose aspirin is required to prevent preeclampsia, although the optimal dosage remains controversial. No universal agreement has been spotted regarding optimal treatment blood pressure (BP) targets, need for treating mild-to-moderate hypertension and postnatal BP measurements. Additionally, while the necessity of antenatal corticosteroids and magnesium sulfate for preterm delivery is universally recommended, the appropriate timing of delivery is not clearly outlined. Hence, there is a need to adopt consistent practice protocols to optimally manage these pregnancies; i.e. timely detect and treat any potential complications and subsequently reduce the associated morbidity and mortality.

Adverse Perinatal Outcomes Associated with Stage 1 Hypertension in Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Elizabeth Norton ◽  
Frances Shofer ◽  
Hannah Schwartz ◽  
Lorraine Dugoff
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorder Of Pregnancy ◽  
Adverse Perinatal Outcomes ◽  
Stage 1 ◽  
In Pregnancy

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points

scholarly journals Evaluation of maternal and fetal outcome in pregnancies complicated by jaundice-an observational study

2021 ◽  
Author(s):  
Ruchi Kishore ◽  
Neha Thakur ◽  
Mitali Tuwani
Keyword(s):  
Mortality Rate ◽  
Observational Study ◽  
Maternal Mortality ◽  
Viral Hepatitis ◽  
Hellp Syndrome ◽  
Fetal Outcome ◽  
Maternal Outcome ◽  
Fetal Mortality ◽  
Maternal Mortality Rate ◽  
In Pregnancy

Background: The spectrum of jaundice in pregnancy varies from a benign condition with good maternal and fetal outcome to a severe form resulting in liver failure and maternal and fetal mortality. Jaundice may complicate 3-5% of pregnancies. Present study was aimed to analyze the cause, course and impact of jaundice during pregnancy so as to have better understanding and hence better feto-maternal outcome. The present study aimed to analyze the various causes of hepatic dysfunction in pregnancy, maternal and fetal outcome in pregnancies complicated by jaundice and various hematological and liver function variables for predicting maternal and fetal outcome.Methods: The present study was an observational study conducted in the department of obstetrics and gynecology, Pt. JNM medical college and associated Dr. BRAM hospital, Raipur (CG) over period of 2 year from September 2018 to September 2020.Results: Total 0.72% pregnancies were complicated by jaundice. HELLP syndrome was the commonest cause of jaundice in pregnancy (36.7%), followed by viral hepatitis (32.7%). Hepatitis E was the most common type of viral hepatitis (91.8%). Hemolytic jaundice presented with best maternal outcome (maternal mortality rate 8.6%). Worst maternal outcome was seen in AFLP (maternal mortality rate 100%). Best fetal outcome was seen in viral hepatitis (live birth rate 67.6%), whereas worst noted with AFLP (fetal death rate 66.6%). Higher total serum bilirubin, higher serum AST, anemia and deranged INR had significant correlation with maternal mortality.Conclusions: HELLP syndrome and viral hepatitis are preventable causes of jaundice yet it contributed to significant proportion of maternal deaths in 26.5 and 18.5% cases respectively. AFLP is often under diagnosed and had a fulminant course in pregnancy causing maternal and fetal mortality.

Sign in / Sign up

Export Citation Format

Share Document