A study of hypertensive emergencies of pregnancy in a tertiary care hospital

Introduction: The American College of Obstetricians and Gynecologists (ACOG) describes a hypertensive emergency in pregnancy as acute-onset, severe hypertension persisting for 15 min or more in setting of preeclampsia or eclampsia. Aim: To study the feto-maternal outcome in hypertensive emergencies in pregnancies. Material and methods: The study was conducted in Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur from June 2018 to August 2019. It was a hospital based descriptive study conducted on 80 pregnant women with hypertensive emergency fulfilling inclusion criteria and exclusion criteria. Goal was to achieve a target BP of less than or equal to 150/100 mmHg. Any Side effects of drugs were noted in both the groups. Monitoring of fetal heart rate was done continuously by electronic cardiotocography until BP remained stable (continuous CTG monitoring). In case of non-reassuring maternal or fetal status the trial protocol was abandoned and appropriate measures were taken. Continuation or termination of pregnancy was decided according to gestational age, maternal and fetal condition. Fetal outcome was noted in terms of number of NICU admission, apgar score. Results Most of the patients were primigravida between age group 18 to 25 years with mean age of 25.83±4.81.77.5% patients were between 28 to 36 weeks of gestation. There was significant decrease in blood pressure after treatment with mean SBP before and after treatment was 185.5±20.18 and 135.37±9.4mmHg respectively. Also the mean DBP before and after treatment was 117.12±13.3 and 85.62±6.5 mmHg respectively. Among the study subjects , about 37.5% delivered vaginally while caesarean section was done in 25% women (table 5).32.6% had APGAR score <7 and number of NICU admission reported in study was 21.1%. There was no perinatal mortality reported in this study. Conclusion A timely intervention of hypertensive disorders complicating pregnancy and provision of specialized systemic antenatal maternal care could reduce the impacts of such complications.