Volume : 6, Issue : 6, June - 2017
Perinatal outcome in early onset PIH in a Tertiary Care Hospital A five year Retrospective Study.
Dr Narahari Agasti, Dr Pramila Jena, Dr Sayantani Nag
Abstract :
<p> <b><span style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman",serif">Introduction & background- </span></b><span style="font-size: 12pt; line-height: 115%; font-family: "Times New Roman", serif;"> Pregnancy Induced Hypertension ( PIH )<b> </b><span style="letter-spacing:-.15pt">is </span>a multiorgan disorder</span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">causing significant maternal and fetal morbidity and mortality.<sup><span style="position:relative;top:-5.5pt;mso-text-raise:5.5pt"> </span></sup>Early onset<b> </b>PIH (< 32 weeks) <span style="letter-spacing:-.15pt">is <o:p></o:p></span></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">associated with more feto-maternal risk than<span style="letter-spacing:.1pt"> </span>PIH occurring at term.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:12.25pt"><b><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman",serif">Materials and Methods:</span></b><span style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman",serif"> This was a Retrospective Observational Study which include 50 <o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:12.25pt"><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman",serif">patients with early onset PIH ( <u>> </u>24 and <u>< </u>34 weeks of gestation) admitted and treated <span style="letter-spacing:-.15pt">in </span>our <o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:12.25pt"><span style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman",serif">hospital <span style="letter-spacing:-.15pt">in </span>the <span style="letter-spacing:-.15pt">last </span>5 years (1<span style="position:relative;top:-5.5pt;mso-text-raise:5.5pt">st </span>January, 2007 to 31<span style="position:relative;top:-5.5pt;mso-text-raise: 5.5pt">st</span>August,<span style="letter-spacing:.35pt"> </span>2011).<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">Retrospective analysis <span style="letter-spacing: .2pt">of </span>the medical records done and perinatal outcome analyzed with <o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">suitable statistical method.<o:p></o:p></span></p> <p class="MsoBodyText" style="margin-top:12.2pt;margin-right:5.5pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:112%"><b>Results: </b>During the study period 1594 women were delivered <span style="letter-spacing:-.15pt">in </span>our hospital. Out of 83 cases of <o:p></o:p></p> <p class="MsoBodyText" style="margin-top:12.2pt;margin-right:5.5pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:112%">PIH only 50 women had early-onset PIH.76 % presented with mild form and 24% presented <o:p></o:p></p> <p class="MsoBodyText" style="margin-top:12.2pt;margin-right:5.5pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:112%"><span style="letter-spacing:.1pt">with </span>severe form of PIH.<span style="position:relative;top:-5.5pt;mso-text-raise:5.5pt"> </span>Most of them presented between 32-34 weeks of gestation. The <o:p></o:p></p> <p class="MsoBodyText" style="margin-top:12.2pt;margin-right:5.5pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:112%">Overall Perinatal Survival Rate was<span style="letter-spacing:-.15pt"> </span>88 % and Perinatal Mortality was<span style="letter-spacing:-.15pt"> </span>12%. <o:p></o:p></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif"> </span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">90.91 % of expectantly managed group had a good perinatal outcome. The perinatal outcome <o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">was better <span style="letter-spacing:-.15pt">in </span>caesarean section group ( 94.74 % survival rate) compared to vaginal delivery <o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">(50 % survival rate). )<b>. </b> 40 % <span style="letter-spacing:.2pt">of </span>the babies were admitted to the NICU. M<span style="letter-spacing:-.15pt">ajor </span>neonatal <o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">complications observed were IUGR (45.83 %), Respiratory Distress Syndrome (12.5 %) and <o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size:12.0pt;line-height:115%;font-family: "Times New Roman",serif">Septicaemia (12.5 %).<o:p></o:p></span></p> <p class="MsoBodyText" style="margin-top:.15in;margin-right:6.0pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:107%"><b>Conclusion & Interpretation</b>: Perinatal mortality and morbidity is significantly higher in early <o:p></o:p></p> <p class="MsoBodyText" style="margin-top:.15in;margin-right:6.0pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:107%">onset PIH. Gestational age, birth weight, mode of delivery, onset and severity of hypertensive <o:p></o:p></p> <p class="MsoBodyText" style="margin-top:.15in;margin-right:6.0pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:107%">disease, method of management ( expectant vs aggressive), availability of neonatal intensive <o:p></o:p></p> <p class="MsoBodyText" style="margin-top:.15in;margin-right:6.0pt;margin-bottom: 0in;margin-left:0in;margin-bottom:.0001pt;line-height:107%">care unit remains the key determinant of perinatal mortality and morbidity.<o:p></o:p></p>
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Download PDF Journal DOI : 10.15373/2249555XCite This Article:
Dr Narahari Agasti, Dr Pramila Jena, Dr Sayantani Nag , Perinatal outcome in early onset PIH in a Tertiary Care Hospital – A five year Retrospective Study., GLOBAL JOURNAL FOR RESEARCH ANALYSIS : VOLUME-6 | ISSUE‾6 | JUNE-2017