Antenatal blood pressure for prediction of gestational hypertension: A prospective observational study

Abstract

Background: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. Early detection of preeclampsia will help reduce the morbidities and mortalities associated with the disorder. The study aims to evaluate the clinical utility of second trimester MAP in the prediction of preeclampsia or gestational hypertension. Methods: This was a prospective cohort study of 200 normotensive, nonproteinuric pregnant women without prior history of gestational hypertension. The women were booked patients attending the antenatal clinic at a tertiary care teaching Hospital, Haldia and were all in their second trimesters of pregnancy. The outcome measures were systolic blood pressure, diastolic blood pressure, and MAP. The end point of the study was the development of preeclampsia or gestational hypertension. The diagnosis of preeclampsia was made by the attending obstetrician. Results: A prospective observational study was carried out on 200 pregnant women between 16-26 weeks of gestation during the time period of 1st Jan 2016- 30th Dec 2016 and results were analyzed. The maximum number of subjects (51.5%) were in the peak reproductive age group of 26-30 years followed by 21.5% and 18% from (21-25 yrs) and 31-35 yrs respectively. The mean age of the study cases was 27.90 years with a SD of ±7.24. The youngest in the study was 19 years of age and eldest was 42 years of age. The parity distribution of the study population was primigravida (39.5%) and 60.5% were multigravida. The development of gestational hypertension among the subjects was 11.5%. Rest of the pregnant women were normotensive. The maximum number of subjects in the gestational hypertension group was in the age group of 26-30 years (n=23, 34.8%) followed by 21-25 yrs age group (30.4%) and 31-35 yrs age group (17.4%). Conclusions: Accurate measurement of blood pressure (BP) is crucial to the diagnosis and management of hypertensive disorders in pregnancy.