Hypertensive Disorders of Pregnancy and its Feto-Maternal Outcome: A Tertiary Care Experience

Background: Hypertensive disorders of pregnancy (HDP) are significant contributors to maternal and perinatal morbidity and mortality globally, with a high impact in both developed and developing countries. These conditions include gestational hypertension, preeclampsia, eclampsia, and chronic hypertension, and contribute to obstetric complications such as placental abruption, intrauterine growth restriction, preterm birth, and stillbirth. Despite improvements in antenatal care, challenges in diagnosis, emergency care, and monitoring contribute to poor outcomes, particularly in resource-limited settings. Tertiary care centres play a crucial role in managing these high-risk pregnancies. Methodology: This prospective observational study was conducted at the ESIC Medical College & Post Graduate Institute of Medical Sciences & Research, Bangalore, from January 2023 to January 2025 involving 250 pregnant women diagnosed with HDP, either booked or unbooked, who met the inclusion criteria. The study assessed various types of hypertensive disorders, including gestational hypertension, preeclampsia, eclampsia, and chronic hypertension, and the maternal and neonatal outcomes. Data was collected through clinical evaluations, laboratory tests, and fetal monitoring. Statistical analysis was performed using SPSS version 21. Results: The study participants had a mean age of 24.62 years, with the majority being gestational hypertension (41.2%) followed by preeclampsia (31.2%). Most women were multigravida (61.2%), and 88% were booked at the hospital. The majority of women (66%) delivered at >37 weeks, while the remainder were preterm. Caesarean section was the most common mode of delivery (54.4%), with fetal distress being the leading indication. Maternal morbidities included postpartum eclampsia (7.6%), HELLP syndrome (7.2%), and postpartum haemorrhage (2.8%). Neonatal outcomes showed that 53 infants were admitted to the NICU, with the leading causes being respiratory distress (33.96%) and jaundice (32.07%). Conclusion: HDP remains a leading cause of maternal and perinatal morbidity in India, especially in tertiary care settings. Early diagnosis, effective management, and prompt referral to specialized centres are critical for improving outcomes. The study highlights the importance of improving referral systems, clinical protocols, and prenatal care to reduce the burden of hypertensive disorders in pregnancy.