Fetomaternal Outcome in Cases of Pregnancy Induced Hypertension in Singleton Pregnancy

Introduction: Pregnancy induced hypertension is a common health problem that affects mother as well as fetus. Hypertensive disorders complicate about 5-10% of all pregnancies and together they are the major contributors of maternal deaths along with infection and hemorrhage. Hypertensive disorders of pregnancy include gestational hypertension, preeclampsia and eclampsia syndrome, pre-existing chronic hypertension and preeclampsia superimposed on chronic hypertension. These are responsible for 9.1% maternal fatalities in Asia and Africa. Approximately 70% of women with PIH will have gestational hypertension-preeclampsia. PIH leads to maternal complications like abruptio placenta, DIC, HELLP syndrome, ARF, intracerebral hemorrhage, pulmonary edema and even death. Prematurity and its associated complications, low birth weight, growth restriction, low APGAR scores, neurologic injury are adverse neonatal effects of the disease. Objective: Present research was conducted to study the fetomaternal outcome in pregnancy induced hypertension (PIH) in singleton pregnancy at tertiary care center. Materials and Methods: Present cross-sectional observational study was conducted at Dhiraj General Hospital (SBKS MI&RC), Piparia, Waghodia, Vadodara, Gujarat among 170 participants over a period of one and a half year. Detailed history including menstrual history, obstetrics history, past history, personal history, marital history, family history of the patient was taken. General and obstetrical examination were carried out. Partographs were used to track intrapartum occurrences. Details including the mode of delivery, the medical care provided, any complications (both maternal and fetal), and eventually the outcome for both the mother and the newborn were documented. Being an observational study rates, ratios and percentages were calculated. Results: PIH incidence rate was 9.5%. Preeclampsia (46.5%) was found to be more common than gestational hypertension (38.8%) and eclampsia (14.7%). PIH was more frequent in the 21 to 25 age group (57.6%) and in primipara. 54.1% patients delivered vaginally while cesarean section was done in 45.9%. Maternal complications like abruptio placenta, PPH, and pulmonary edema were seen in 4.7%, 2.35%, and 2.35% of women, respectively. Maternal mortality was seen in 0.6% of the women with PIH. Low birth weight was found in 52.4% of newborns while the rates of IUD, stillbirth, and infant mortality were 5.9%, 1.2%, and 1.8%, respectively. Conclusion Pre-eclampsia and Eclampsia still remains a big concern in pregnancy. Feto-maternal outcomes are susceptible to deterioration in the presence of PIH. In situations of eclampsia, early administration of antihypertensive medicines, optimal timing of delivery, proper fluid balance, and anticonvulsants aid in achieving a favorable result. Early registration and frequent ANC visits in order to identify pregnancy-induced hypertension as early as possible is advocated to avoid its severity and related consequences. Detection and control of problems at an early stage and timely referral are essential for ensuring a good outcome for both mother and child.