Abstract

Background: Hypertensive disorder represents a common medical complication of pregnancy affecting 7-15% of all gestations and account for approximately a quarter of all antenatal admissions. Aim of this study was to identify the prevalence of pregnancy induced hypertension (PIH) as well as their outcomes depending upon the diversity of presentation and also to evaluate the risk factors and patients’ negligence that can be avoidable.
Methods: This cross-sectional study was carried out at the Department of Obstetrics & Gynecology of Shaheed Ziaur Rahman Medical College Hospital, Bogura over the period of January 2020 to December 2020. Total 100 PIH patients were selected among the PIH patients who are admitted into the Obstetrics & Gynecology ward of Shaheed Ziaur Rahman Medical College Hospital (SZMCH) by purposive sampling technique. Inclusion criteria were: patients having hypertensive disease during pregnancy, gestational age more than 20 completed weeks, both primigravida and multipara. Exclusion criteria were:   congenital heart disease.
Results: The result showed that most (64%) of PIH patients were 2nd and 3rd Gravida, having bad obstetric history (BOH)  (60%) cases, unplanned pregnancy 81%, 50% having no ANC with 66% unbooked, 70% were at preterm pregnancy (28-37 weeks) belong to lower middle class and poor socioeconomic condition (89%), depending upon their classical symptom they are categorized as Pre-eclampsia (PE) with severe symptom(39%), Eclampsia (28%), PE without sever symptom (21%), Superimposed PE (8%), and gestational hypertension (HTN)(4%).  Most common presentation was convulsion (28%) and among them antepartum convulsion was most common (60.71%). Regarding maternal outcome, mortality was 21%; 50% showed varieties of morbidity, most common was puerperal sepsis (42%). 54% patients were delivered by Lower Segment Cesarean Section (LSCS) and 35.72% improved by the end of 1st postpartum day. Regarding investigations 42% patients showed severe proteinuria, 65% patient mildly anemic; 58% showed leukocytosis; 92% raised uric acid; 38% decreased serum albumin; 100% impaired liver function tests (LFT) different category, most common comorbidity was diabetes mellitus (17%). Regarding fetal outcome mortality was 24% and morbidity was 41%; among them most common morbidity was IUGR (11%). 50% babies APGAR score in 1St minute was (5-7) and most of the babies (61-83%) birth weight was within 1.6-2.5 kg.
Conclusion: PIH remain undiagnosed in younger age group and low-family-income patients due to poverty and lack of knowledge. So, we should be cautious about the diversities of presentation of PIH case and should pay attention to avoid the probability of under-diagnosis, in order to prevent maternal and neonatal complications to achieve the targets of maternal mortality up to 70 / Lakh Live births and perinatal mortality up to 12/1000 live births by the year 2030.

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