FETOMATERNAL OUTCOMES REGARDING HYPERTENSIVE DISORDERS IN PREGNANCY

Abstract

Background: Hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia, and eclampsia, are among the leading causes of maternal and perinatal morbidity and mortality worldwide. These conditions pose serious threats to both mother and fetus, particularly in low- and middle-income countries where early detection and management may be limited.

Aim: To determine the fetomaternal outcomes associated with hypertensive disorders of pregnancy in women admitted to a tertiary care hospital in Lahore, Pakistan.

Methodology: This descriptive case series was conducted over six months in the Department of Obstetrics and Gynecology at Gulab Devi Teaching Hospital, Lahore. A total of 180 pregnant women aged 20–38 years diagnosed with hypertensive disorders were enrolled using non-probability consecutive sampling. Women with chronic comorbidities or incomplete postpartum follow-up were excluded. Data on maternal demographics, clinical features, delivery mode, and neonatal outcomes were collected and analyzed using SPSS version 28. Descriptive statistics were used to summarize findings, and Chi-square tests were applied to determine associations, with p ≤ 0.05 considered statistically significant.

Results: Among the 180 participants, 46 (25.6%) had gestational hypertension, 32 (17.9%) mild preeclampsia, 95 (52.6%) severe preeclampsia, and 5 (2.6%) eclampsia. Cesarean delivery rates were significantly higher in severe preeclampsia (49.5%) and eclampsia (60%) compared to normotensive controls (21.6%) (p = 0.009). Preterm birth before 37 weeks occurred in 35.8% of severe preeclampsia and 80% of eclampsia cases (p < 0.001). Low birth weight (<2500 g) was observed in 42.1% of severe preeclampsia and 60% of eclampsia (p < 0.001). Poor Apgar scores, increased NICU admissions, and higher rates of IUGR were significantly associated with disease severity. Stillbirth rates were numerically higher in hypertensive groups but not statistically significant (p = 0.65).

Conclusion: The study highlights a strong correlation between increasing severity of hypertensive disorders in pregnancy and adverse maternal and neonatal outcomes. Findings support the need for vigilant antenatal screening, timely intervention, and resource-appropriate management strategies to mitigate the risks associated with HDP.