Jalagadugula Venkata Narasimha Rao1, Jalagadugula Chandini2
BACKGROUND
Pregnancy-Induced Hypertension (PIH) contributes significantly to maternal and perinatal morbidity and mortality. Women with PIH are at a greater risk of abruptio placentae, cerebrovascular events, organ failure and disseminated intravascular coagulation. Foetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity and intrauterine death. PIH brings about histomorphological changes in the placenta thereby resulting in placental dysfunction. Present study aims to understand the morphological changes in the placenta along with maternal and foetal outcomes in pregnancies complicated by PIH. MATERIALS AND METHODS
A descriptive observational case-control study was conducted from March 2013 to April 2016 in a tertiary care hospital. Hundred women diagnosed with PIH and hundred women with normal gestation were enrolled in the study. Foetal and maternal outcome at term was evaluated in comparison to normal gestation. Placental specimens from term gestations (38-42 weeks) diagnosed with PIH and placenta from normal full-term gestations were studied to assess the morphological parameters. Statistical analysis was done using descriptive statistical measures.
RESULTS
A total of 100 cases with PIH and 100 control normotensive gestations were included in the present study. Gestational hypertension accounted for 66 cases, preeclampsia 23 and eclampsia 11 cases. Liver infarcts were the commonest maternal complication (11%) among the cases followed by renal failure and postpartum haemorrhage (5% each), however, no maternal mortality was documented in our study. Total number of preterm deliveries was 35 and foetal demise was documented in 9 cases. Low birth weight was the commonest foetal complication seen in 37% of the cases. Mean placental weight of PIH cases was found to be 406.5 g, which was significantly lesser than the mean weight of the control group placenta. Multifocal infarcts, retroplacental clots, fibrinoid necrosis and areas of calcification were significantly associated with placental specimens from PIH cases.
CONCLUSION
The study describes the various maternal, foetal and placental outcomes in pregnancies complicated by PIH. The presence of preeclampsia and eclampsia remain the major contributors to maternal and foetal outcome. Regular antenatal checkups, multidisciplinary treatment, optimum timing of delivery and prompt perinatal management reduces fetomaternal complications and mortality.
