COMPARATIVE STUDY OF FOETAL AND MATERNAL OUTCOME IN CONTROL OF GESTATIONAL HYPERTENSION BY ASSESSING THE MEAN ARTERIAL PRESSURE (> 105 - < 125) AND CONVENTIONALLY TREATING BLOOD PRESSURE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 32
Abstract
BACKGROUND Hypertensive disorders complicate 5% - 10% of all pregnancies and contribute greatly to maternal and foetal morbidity and mortality. There is a lack of consensus on the classification/ definition of hypertensive disorders of pregnancy, the Blood Pressure (BP) level at which anti-hypertensive therapy needs to be initiated, the appropriate anti-hypertensive agent and maternal and foetal risk-benefit ratio of treatment. It is generally agreed that severe hypertension (diastolic BP >= 110 mmHg) requires treatment due to risk of cardiovascular and/or target organ damage. However, in mild-to-moderate hypertension, there is no consensus regarding the blood pressure at which treatment needs to be initiated. Aim- To compare maternal and foetal outcome of patients in whom anti-hypertensive treatment was started at Mean Arterial Pressure (MAP) of 106 – 109 mmHg and in whom anti-hypertensive treatment was started at MAP >= 110 mmHg. MATERIALS AND METHODS This is a randomised controlled trial study of patients from Department of Obstetrics and Gynaecology, Government Medical College, Kozhikode, from April 2014 to March 2015. Hundred patients were selected in each group on diagnosing hypertension with the above-mentioned mean arterial pressure and were initiated on anti-hypertensive treatment and managed as per protocol. Statistical analysis was done by SPSS 16. Data was analysed with Chi-square test and Fisher’s exact test. RESULTS In our study, 70% of women in either group were in the age group of 21 - 30 years. Gestational hypertension was found more commonly in primigravidae. There was no significant difference between various drug usages in controlling blood pressure. At initial presentation, the incidence of pre-eclampsia was 37% in patients with MAP 106 – 109 mmHg and there was a lesser incidence of proteinuria when anti-hypertensives were initiated in mild hypertension. An improved renal function and an overall reduction in maternal complications were found on early initiation of anti-hypertensive therapy. CONCLUSION Gestational hypertension is more common in primigravidae during 3rd decade of life. Maternal and foetal complications were significantly reduced, and perinatal outcome was better when anti-hypertensives were started with the MAP of 106 – 109 mmHg at initial diagnosis. There was no difference between drugs used with regard to control of blood pressure and the need for an additional drug
Authors and Affiliations
Ramlath T. P, Sudhamani C
Keywords
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- EP ID EP541175
- DOI 10.14260/jemds/2018/806
- Views 214
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