Study Of Risk Factors of Perinatal Death in Pregnancy Induced Hypertension (PIH)

Authors

  • Mehul T Parmar Government Medical College, Bhavnagar, Gujarat, India
  • Harsha M Solanki Government Medical College, Bhavnagar, Gujarat, India
  • Vibha V Gosalia Government Medical College, Bhavnagar, Gujarat, India

Keywords:

Pregnancy induced Hypertension, Risk Factors, Perinatal Death

Abstract

Background: Hypertensive disorders are common complication occurring during pregnancy responsible for maternal & fetal mortality & morbidity. Though the condition is on decline, still stands a public health problem.

Objectives: To determine risk factors of perinatal death in women with pregnancy induced hypertension.

Materials & Method: A cross-sectional study was conducted over period of one year in the department of Obstetrics & Gynecology in NHL municipal college, Ahmadabad.  A total of 100 pregnant women with PIH were enrolled in the study. A pre-tested structured Performa was prepared & women were interviewed to collect necessary information such as detailed history, clinical examination findings & investigations performed. Results were analyzed using MS Excel & Epi Info.

Results: In the present study, 29%, 21% & 50 % were of mild PIH, moderate PIH & severe PIH respectively. The incidence of PIH was found more among teenage pregnancy, among primigravidas, those from low socio-economic status, those with history of PIH in previous pregnancy, having family history of PIH & those who were found obese. Emergency delivery, having diastolic blood pressure > 90 mm Hg, higher degree of proteinuria & low birth weight among PIH cases had an adverse perinatal outcome in terms of higher perinatal death. The findings were statistically significant On Univariate analysis; diastolic blood pressure & degree of proteinuria were found to be significant risk factors responsible for perinatal mortality among PIH women.

Conclusion: Pregnancy induced hypertension is a common medical disorder associated with pregnancy. In the present study, PIH cases who delivered in emergency, with raised diastolic blood pressure & more proteinuria & neonate with low birth weight were found risk factors for perinatal death. Fetal morbidity & mortality can be reduced by early recognition & institutional management.

References

Gary F. Hypertensive disorders in pregnancy. Cunningham Williams Obstetrics. 22nd edition. New York: Mc Graw Hill publishing division: 2005. p761.

Chee Jing Jye. Challenges of obstetrician in the management of severe preeclampsia. Obs and Gynae Today 2009; 16(8):348-51.

Dadelszen P, Magee L. What matters in preeclampsia are the associated adverse outcomes: the view from Canada. Current opinion in obstetrics and Gynaecology 2008;20:110-15.

National High Blood Pressure Education Program Working group. Report of the National High Blood Pressure Education Program working group on High Blood Pressure in pregnancy. Am J Obstet Gynecol 2000;183:1-22.

Brown MA, Hague WM, Higgins J. The detection, investigation and management of hypertension in pregnancy: full consensus statement. Aust N Z J Obstet Gynecol 2000;139-55.

Walker J. J, Gant N. F. Hypertension in pregnancy. 1st edition. CRC publisher: 1997.p 1.

Hypertension in Pregnancy: the management of hypertensive disorders of pregnancy. 1st ed. London: The Royal College of obstetricians & Gynaecologist; August 2010. p 2.

Martin JA, Hamilton BE, Ventura SJ, et al. Births: Final data for 2009. National vital statistics reports; vol 60 no 1. Hyattsville, MD: National Centre for Health Statistics. 2011. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_01.pdf

Bangal V, Giri P, Mahajan A. Maternal and foetal outcome in pregnancy induced hypertension: a study from rural tertiary care teaching hospital in India. International Journal of Biomedical Research IJBR 2011; 2(12):595‐599.

Duckitt K, Harrington D. Risk factors for preeclampsia at antenatal booking: systematic review of controlled studies. BMJ 2005;330: 565-577.

Saha S. et al. Comparative study on the efficacy of magnesium sulphate and diazepam in the management of eclampsia in a peripheral rural medical college. Ind J Obstet Gynecol 2002;52(3):69-72.

Lamminpaa R et al. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997-2008. BMC Pregnancy Childbirth 2012;12(1):47.

Jasovic Siveska, Jasovic V, Stoilova S. Previous Pregnancy History, Parity, Maternal age & risk of PIH. Bratisl Lek Lysti 2011;112(4):188-91

Yucesoy G. et al. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: a seven year experience of a tertiary care center. Arch Gynecol Obstet. 2005;273(1):43-9.

Bhattacharya M. Pregnancy induced hypertension and prior trophoblastic exposure. Ind J Obstet Gynecol 2004; 54 (6): 568-70.

S Ganesh Kumar et a. Determinants of pre-eclampsia: A case-control study in a district hospital in South India. Indian J of Community Medicine2010;35(4):502-505.

Miguil M, Chekairi A. Eclampsia, Study of 342 cases. Hypertension & Pregnancy. 2008; 27 (2):103-11.

Dissanayake VH et al. Morbidity and mortality associated with preeclampsia at two tertiary care hospitals in Sri Lanka. J Obstet Gynaecol Res.2007;33 (1):56-62.

Dhananjay BS. et al. A Study of Factors Affecting Perinatal Mortality in Eclampsia JPBS 2009;22(2): 2-5

Bellamy L et al. Preeclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ 2007;335:974 –977.

Ferrazzani S et al. Proteinuria and outcome of 444 pregnancies complicated by hypertension. Am J Obstet Gynecol 1990;162: 366–71.

Waugh JJS et al. Urine protein estimation in hypertensive pregnancy: Which thresholds and laboratory assay best predicts clinical outcome. Hypertens Pregnancy In Press.

Schiff E et al. The importance of urinary protein excretion during conservative management of severe pre-eclampsia. Am J Obstet Gynaecol 1996;175:1313–316.

Downloads

Published

2012-12-31

How to Cite

1.
Parmar MT, Solanki HM, Gosalia VV. Study Of Risk Factors of Perinatal Death in Pregnancy Induced Hypertension (PIH). Natl J Community Med [Internet]. 2012 Dec. 31 [cited 2024 Nov. 28];3(04):703-7. Available from: https://njcmindia.com/index.php/file/article/view/1799

Issue

Section

Original Research Articles