Obstetric and perinatal outcomes of childbirth in women with hypertensive disorders
DOI:
https://doi.org/10.32782/2077-6594/2023.4/09Keywords:
hypertensive disorders during pregnancy, preeclampsia, gestational hypertension, pregnancy and childbirth complications, perinatal complicationsAbstract
Preeclampsia (PE) is a human-specific disorder, occurring after the 20th week of pregnancy, defined by increased blood pressure over 140/90 mmHg and proteinuria exceeding 300 mg/day. It's a major contributor to maternal mortality, ranking second as per WHO data. Purpose. This study aims to assess the obstetric and perinatal outcomes of childbirth in women with hypertensive disorders during pregnancy, based on a retrospective analysis. Materials and methods. The study involved a retrospective review of 100 pregnancy and childbirth cases at Zaporizhia's perinatal center, focusing on singleton pregnancies complicated by gestational hypertension, moderate, or severe PE. Analysis utilized clinical, anamnestic data, and statistical tools like Microsoft Excel and STATISTICA 13. Results. Findings showed gestational hypertension in 34% of cases, moderate PE in 55%, and severe PE in 11%. Notable perinatal outcomes included preterm birth in 37% of cases, utero-fetal-placental blood flow disruptions in 63%, and fetal distress in 23%. A negative correlation was identified between hypertensive disorder severity and delivery term (ρ= -0.393, p < 0.01). Conclusions. Hypertensive disorders, especially PE, significantly impact pregnancy and perinatal outcomes, leading to high rates of premature births, disruptions in utero-fetal-placental hemodynamics, and fetal growth restriction in newborns. The study underscores the importance of early diagnosis and comprehensive treatment of hypertensive disorders during pregnancy to mitigate adverse perinatal outcomes.
References
Tranquilli AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, Zeeman GG, Brown MA. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens. 2014;4(2):97–104. https://doi.org/10.1016/j.preghy.2014.02.001.
Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice. Hypertension. 2018;72(1):24–43. https://doi.org/10.1161/HYPERTENSIONAHA.117.10803.
Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ. Pre-eclampsia. Lancet. 2016;387(10022):999–1011. https://doi.org/10.1016/S0140-6736(15)00070-7.
Phipps EA, Thadhani R, Benzing T, Karumanchi SA. Pre-eclampsia: pathogenesis, novel diagnostics and therapies. Nat Rev Nephrol. 2019;15(5):275–289. https://doi.org/10.1038/s41581-019-0119-6.
Ranjbar A, Taeidi E, Mehrnoush V, Roozbeh N, Darsareh F. Machine learning models for predicting pre-eclampsia: a systematic review protocol. BMJ Open. 2023;13(9):e074705. https://doi.org/10.1136/bmjopen-2023-074705.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–e333. https://doi.org/10.1016/S2214-109X(14)70227-X.
World Health Organization. Trends in maternal mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva, Switzerland: WHO; 2023. Available from: https://www.who.int/reproductivehealth/publications/maternal-mortality-2000-2020/en/.
Ward ZJ, Atun R, King G, Sequeira Dmello B, Goldie SJ. Simulation-based estimates and projections of global, regional and country-level maternal mortality by cause, 1990-2050. Nat Med. 2023;29(5):1253–1261. https://doi.org/10.1038/s41591-023-02310-x.
Trost SL, Beauregard J, Petersen EE, Cox S, Chandra G, St Pierre A, et al. Identifying Deaths During and After Pregnancy: New Approaches to a Perennial Challenge. Public Health Rep. 2023;138(4):567–572. https://doi.org/10.1177/00333549221110487.
Aukes AM, Arion K, Bone JN, Li J, Vidler M, Bellad MB, et al. Causes and circumstances of maternal death: a secondary analysis of the Community-Level Interventions for Pre-eclampsia (CLIP) trials cohort. Lancet Glob Health. 2021;9(9):e1242–e1251. https://doi.org/10.1016/S2214-109X(21)00263-1.
Abstracts of the XXII FIGO World Congress of Gynecology & Obstetrics. Int J Gynaecol Obstet. 2018;143 Suppl 3:43–991. https://doi.org/10.1002/ijgo.12584.
Geary M, Goggins A. Selected papers from the XXIII FIGO World Congress. Int J Gynaecol Obstet. 2023;160(2):457–458. https://doi.org/10.1002/ijgo.14624.
Shennan A, Suff N, Jacobsson B, the FIGO Working Group for Preterm Birth, Simpson JL, Norman J, et al. Abstracts of the XXIII FIGO World Congress of Gynecology & Obstetrics. Int J Gynaecol Obstet. 2021;155 Suppl 2(1):31–532. https://doi. org/10.1002/ijgo.13884.
Ministerstvo okhorony zdorov'ya Ukrayiny. Unifikovanyy klinichnyy protokol pervynnoyi, vtorinnoyi (spetsializovanyy) ta tretinnoyi (vysokospetsializovanyy) medychnoyi dopomohy «Hipertenzyvni rozlady pid chas vahitnosti, polohiv ta u pisliahpolohovomu periodi». Nakaz No. 151 vid 24 sichnya 2022 roku. Available from: https://www.dec.gov.ua/wp-content/uploads/2022/01/2022_151_ykpmd_giprozlvagitn.pdf.
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