Abstracto

Maternal morbidity with early onset hypertensive disorders during pregnancy

Chhabra S and Singh A

Background: Hypertensive disorders of pregnancy (HDsP) are being divided into early onset (EO), late onset (LO) disorders, depending upon gestation at diagnosis, because of differences in causes, pathology, outcome and sequale. It seems EO HDsP cause much more morbidity in the mother. Objective: To know differences in maternal morbidity EO HDsP compared to late onset disorders. Material Method: Study was done to know complications in cases of 1046 cases of EO LO HDsP, managed over 2 years, 11.73% of 8920 births during the study period. EO cases were (Category A)-20 to <28 weeks, (B) ? 28-<34 weeks and LO, (C) ? 34-<37 weeks, (D) ? 37 weeks. Results: Significantly more women with EO HDsP were primigravida of younger age. Significantly more women with very EO HDsP (Category A) had liver dysfunction compared to Category B, C, D, 85% had mild preeclampsia, 60% severe in A, 32% mild PE 27% severe PE, in LO cases, 9.58% mild PE, 50% severe PE in C, 19.56% mild PE in D, 44.11% severe PE. HELLP (Hemolysis, Elevated Liver enzymes and Low Platelet count) as well as renal failure were also more often diagnosed in EO cases. In LO no patient had grade III hypertensive retinopathy. Placental abruption occurred in 25% A, 14.66% B, 3.79% C, 2.67% D. There was no maternal death with individualized management. Conclusion: Younger women had EO disorders which were more often severe. There were more chances of multiorgan disorders in women with EO disorders compared to LO.