Hypertensive Disorders During Pregnancy, Fatal Effects on Mother and Baby-Prevention a Challenge in Low Resource Settings

Background: Hypertensive disorders during pregnancy (HDsP), unpredictable, multifaceted disorders which can rapidly develop into dangerous eclampsia and /or life-threatening multiorgan dysfunction, are major causes of morbidity, mortality of mothers, babies.

Objective: Objective was to know status of maternal severe morbidity, mortality and perinatal mortality due to HDsP at a rural institute.

Materials and Methods: Present study was conducted in obstetrics gynecology of a rural institute of low resource region.

Results: There were 34089 obstetric cases admitted over 5 years of analysis period. Of them 4201 had HDsP, 12.32% of all cases. Severe morbidity due to HDsP occurred in 348 (8.28%) women who had HDsP. Of 348 cases with SM ,150 (3.57% of all HDsP) and 18% of all SM, had placental abruption, 63 (1.49% of all HDsP), 18.1% of SM had HELLP, 59 (1.40% of all HDsP), 16.95% of cases of SM had Pulmonary edema, 5 (0.11% of HDsP), 1.43% of all SM, had renal failure, and 71 (1.69% of all HDsP), 20.40% of SM had coagulation failure. Fifteen maternal deaths occurred due to HDsP, 0.35% of 4201 cases of HDsP, 4.31% of 348 cases of severe morbidity due to HDsP. Maternal deaths due to HDsP contributed to 24.6% of overall maternal mortality. Overall 153 perinatal deaths occurred in HDsP cases. contributing to 15.69% perinatal deaths in the same period.

Conclusion: In low resource region incidence of HDsP was high, severity and case fatality were also high. They contributed to a lot of maternal mortality and perinatal mortality.

Keywords:Hypertensive disorders; Pregnancy; Severe morbidity; Mortality; Perinatal mortality