Outcomes in hypertensive disorders of pregnancy in the North Indian population

Figures & data

Table 1 Demographic profile

Group	Control (n = 31)	Mild preeclampsia (n = 65)	Severe preeclampsia (n = 32)	Eclampsia (n = 45)	P value
Age group, % (n)
<25 years	29.03 (9)	23.08 (15)	37.50 (12)	42.22 (19)	0.136
25–35 years	70.97 (22)	76.92 (50)	59.38 (19)	57.78 (26)
>35 years	0.00 (0)	0.00 (0)	3.13 (1)	0.00 (0)
Gravida, % (n)
0–1	41.94 (13)	50.77 (33)	53.13 (17)	57.78 (26)	0.548
1–2	32.26 (10)	26.13 (17)	18.75 (6)	24.44 (11)
2–3	16.13 (5)	13.85 (9)	12.50 (4)	11.11 (5)
3–4	6.45 (2)	1.54 (1)	9.38 (3)	2.22 (1)
4–5	3.23 (1)	6.15 (4)	0.00 (0)	4.44 (2)
5–6	0.00 (0)	1.54 (1)	6.25 (2)	0.00 (0)
Socioeconomic status, % (n)
Low	12.90 (4)	32.31 (21)	28.13 (9)	73.33 (33)	0.0001
Medium	87.10 (27)	67.69 (44)	71.88 (23)	26.67 (12)
History of hypertensive disease in pregnancy, % (n)
Not present	100.00 (31)	96.92 (63)	96.88 (31)	100.00 (45)
Present	0.00 (0)	3.08 (2)	3.13 (1)	0.00 (0)
CNS, % (n)
Normal	100.00 (31)	100.00 (65)	100.00 (32)	57.78 (26)	0.000
Abnormal	0.00 (0)	0.00 (0)	0.00 (0)	42.22 (19)
Hypertension, mmHg
Mean SBP	117.84 ± 4.7	145.32 ± 9.7	159.88 ± 8.3	156.89 ± 9.50	<0.0001
Mean DBP	77.42 ± 6.8	93.72 ± 5.2	103.25 ± 7.6	101.20 ± 7.90	<0.0001
Urine output, % (n)
<400 mL/24 hours	0.00 (0)	0.00 (0)	18.75 (6)	20.00 (9)	0.001
>400 mL/24 hours	100.00 (31)	100.00 (65)	81.25 (26)	80.00 (36)

Note: The difference between two values was considered significant if P < 0.05.

Abbreviations: CNS, central nervous system; DBP, diastolic blood pressure; SBP, systolic blood pressure.

Table 2 Clinical manifestations of hypertensive disorders of pregnancy at presentation (n = 142)

Clinical features	Patients, n	%
Hypertension	142	100.00
Edema	128	90.00
Proteinuria
≥ 300 mg/dL	38	26.76
≥ 2 g/dL	68	47.88
3–5 g/dL	36	25.35
Central nervous system	19	42.20
Jaundice	81	57.00
Visual symptoms	9	6.40
Vaginal bleeding	16	11.30
HELLP syndrome	4	2.80

Abbreviation: HELLP, hemolysis, elevated liver enzymes, and low platelet count.

Table 3 Biochemical parameters

Investigation	Control (n = 31)	Mild preeclampsia (n = 65)	Severe preeclampsia (n = 32)	Eclampsia (n = 45)	P value
Hemoglobin (g/dL)	10.81 ± 0.5	9.58 ± 1.4	9.71 ± 1.2	9.24 ± 1.0	0.0059
Platelet count (lac/mm^3)	2.10 ± 0.3	1.64 ± 0.4	1.59 ± 0.4	1.65 ± 0.4	<0.001
Serum urea (mg/dL)	20.03 ± 4.1	30.05 ± 9.7	38.72 ± 9.7	32.08 ± 75	<0.001
Serum creatinine mg/dL	0.60 ± 0.2	1.27 ± 0.5	2.67 ± 1.3	1.95 ± 0.7	<0.001
Serum bilirubin (mg/dL)	0.49 ± 0.3	1.31 ± 0.8	1.89 ± 1.2	1.86 ± 0.8	<0.001
Serum ALP (IU/L)	61.84 ± 9.3	359.40 ± 164.5	337.34 ± 188	443.60 ± 168.1	<0.001
Serum GPT (IU/L)	47.77 ± 13.8	215.94 ± 125.8	257.72 ± 174.1	354.89 ± 193.2	<0.001
Serum GOT (IU/L)	49.71 ± 4.4	208.57 ± 130.9	299.00 ± 167.8	338.09 ± 173.1	<0.001
Serum uric acid (mg/dL)	2.24 ± 0.5	7.36 ± 1.8	8.36 ± 1.8	6.61 ± 2.0	<0.001
Serum LDH (IU/L)	186.48 ± 41.9	735.75 ± 268.5	959.13 ± 238.2	868.67 ± 247.7	<0.001

Note: The difference between two values was considered significant if P < 0.05.

Abbreviations: ALP, alkaline phosphatase; GOT, glutamic oxaloacetic transaminase; GPT, glutamate pyruvate transaminase; LDH, lactate dehydrogenase.

Table 4 Distribution of various maternal complications among study groups (%)

Maternal complication	Control (n = 31)	Mild preeclampsia (n = 65)	Severe preeclampsia (n = 32)	Eclampsia (n = 45)
Acute renal failure	0.00	0.00	3.13	0.00
Abruption	0.00	15.38	25.00	15.56
Cerebrovascular accident	0.00	0.00	0.00	2.22
PPE	0.00	12.50	27.27	14.29
Postpartum hemorrhage	3.22	9.23	12.50	11.10
Pulmonary embolism	0.00	0.00	0.00	2.22
Chronic hypertension	0.00	1.53	6.25	2.22
Focal deficit	0.00	0.00	0.00	2.22
Death	0.00	0.00	0.00	8.89

Abbreviation: PPE, post partum eclampsia.

Table 5 Distribution of mode of delivery and fetal outcome

Fetal outcome	Control (n = 31)	Mild preeclampsia (n = 65)	Severe preeclampsia (n = 32)	Eclampsia (n = 45)	HDP group (n = 142)
Mode of delivery
Normal	21 (67.74%)	40 (61.54%)	18 (56.25%)	29 (44.44%)	87 (61.26%)
Instrumental	0	1 (1.54%)	0	1 (2.22%)	2 (1.40%)
LSCS	10 (32.26%)	24 (36.92%)	14 (43.75%)	15 (33.33%)	63 (37.32%)
Fetal weight, g
< 1500 g	–	3 (4.62%)	1 (3.13%)	5 (11.20%)	9 (6.33%)
1500–2499 g	7 (22.60%)	33 (50.76%)	28 (87.50%)	10 (22.30%)	71 (50.00%)
> 2500 g	24 (77.40%)	29 (44.62%)	3 (9.40%)	30 (66.70%)	62 (43.70%)
Stillborn	0	5 (7.69%)	5 (15.60%)	14 (31.10%)	24 (16.90%)

Abbreviations: HDP, hypertensive disorders complicating pregnancy; LSCS, lower segment cesarean section.

Table 6 Neonatal outcome

Group	Control (n = 31)	Mild preeclampsia (n = 60)	Severe Preeclampsia (n = 27)	Eclampsia (n = 31)	Total (n = 118)
Apgar score <7	2 (6.45%)	7 (11.67%)	2 (7.40%)	11 (35.48%)	20 (16.90%)
Apgar score >7	29 (93.55%)	53 (88.30%)	25 (92.60%)	20 (64.52%)	98 (83.05%)
Required resuscitation	2 (6.50%)	11 (18.40%)	11 (40.75%)	12 (38.70%)	118 (28.80%)
NICU admission	2 (6.50%)	8 (13.40%)	7 (25.90%)	9 (29.10%)	24 (20.35%)
Neonatal death	–	1 (1.70%)	1 (3.70%)	3 (9.70%)	5 (4.23%)

Abbreviation: NICU, neonatal intensive care unit.