Fetal Outcome of Pregnancy with Hypertension

Abstract

Objective: To assess relationship of neonatal morbidity and mortality with severity of
hypertension. The effect of severity of hypertension on time of delivery and neonatal outcome
including birth weight, APGAR score, neonatal nursery admission, intrauterine death and
neonatal deaths was studied.
Methods: All pregnant patients with diastolic blood pressure of at least 90 mmHg or systolic
blood pressure of 140 mmHg taken at two occasions at least 6 hours apart, with singleton
pregnancy at any gestational age were included in the study. They were categorized in two groups
according to diastolic blood pressure at the time of presentation. Mild to moderate hypertensive
patients were those with diastolic blood pressure up till 109 mmHg. Patients with diastolic blood
pressure 110 mmHg or more were labeled as severely hypertensive patients. All patients were
followed throughout antenatal period till delivery. Time of delivery was decided by senior
consultants according to obstetrical parameters. All babies delivered were attended by
pediatricians and admission in neonatal nursery was decided by pediatricians. Babies admitted in
nursery were followed till discharge or expiry.
Results: Out of 1661 screened patients, 119 hypertensive pregnant patients were detected (an
incidence of 7.16%). Out of these 78.2% were mild to moderate hypertensive and 21.8% were
severely hypertensive patients. The effect of severity of hypertension was significant on time of
delivery. There were 74% preterm deliveries in severely hypertensive patients as compared to
13% in mild to moderate group (p= 0.0001). The effect of severity of hypertension was significant
on birth weight, APGAR score, intrauterine and neonatal deaths.
Conclusion: Fetal morbidity and mortality is directly related to severity of hypertension in terms
of birth weight, pre-term deliveries,APGAR score and perinatal mortality rate