Maternal and Perinatal Outcome of Hypertensive Disorders of Pregnancy at a Tertiary Care Hospital

Objective: To study the frequency of various hypertensive disorders of pregnancy and to determine theirmaternal and perinatal outcome. Study Design: Retrospective descriptive study. Place and Duration of Study: Department of Obstetrics & Gynecology Unit III, Civil Hospital Karachi, fromJanuary 2002 to December 2007.Patients and Methods: A total of 626 cases were reviewed for age, parity, gestational age, diagnosis, antenataland intra partum complications, mode of delivery and neonatal outcome. Data was analyzed using SPSSsoftware (version 16). Results: Total number of deliveries during the study period was 11,718 and there were 626 cases of hypertensivedisorders of pregnancy giving a frequency of 5.34%. Pre-eclampsia was seen in 308 (49%), severe pre-eclampsiain 85 (13%), eclampsia in 121 (19.2%), chronic hypertension in 41(6%) and postpartum eclampsia in 21 (3.3%)patients. There were 39 maternal deaths (case fatality rate: 6.23%). The mean ages for pre-eclampsia, severepre-eclampsia, eclampsia and chronic hypertension were 28, 27, 24 and 29 (27 years) years respectively. Thecommonest maternal complication of hypertensive disorders was postpartum hemorrhage in 24 women (4.2%).This was followed by placental abruption in 9 women (1.6%) and pulmonary edema in 8 women (1.4). Theprevalence of prematurity in pre-eclampsia, severe pre-eclampsia and eclampsia in study population was 14%,5% and 8.6% respectively. Cesarean section was required for pre-eclampsia, severe pre-eclampsia and eclampsiain 46%, 51% and 61% of patients respectively. The main fetal complications were found to be still birth (14%in pre-eclampsia, 18% in severe pre-eclampsia and 15% in eclampsia) and low birth weight (31% in preeclampsia,49% in severe pre-eclampsia and 52% in eclampsia). Conclusion: Hypertensive disorders inpregnancy are an important cause of maternal and perinatal mortality and morbidity.