DETERMINANTS OF MORTALITY AND COMPLICATIONS IN HYPERTENSIVE DISORDERS OF PREGNANCY : A SINGLE CENTER EXPERIENCE

Our retrospective cohort study set out to identify the determinants of adverse maternal and perinatal outcome in patients admitted to intensive care (ICU) with severe features of Hypertensive Disorders of Pregnancy(HDP).Case files of patients with severe pre-eclampsia and eclampsia (including HELLP syndrome) were analyzed.The prevalence of HDP was 6.01% and eclampsia 0.99%. Parity did not affect the severity of disease nor survival. The incidence of chronic hypertension was 15.38% and 12.5% in survivors and non-survivors respectively. There was a high number of patients who did not receive any antenatal care prior to admission in both the groups [69% and 87%]. Severe anemia was significantly higherin non-survivors (42%) than in survivors (13%). Symptoms such as blurred vision, respiratory distress, oliguria, altered sensorium and absent fetal movements were prognostic markers. Multiple seizures and a time lapse between the onset of symptoms and administration of magnesium sulfate produced an increased mortality. The stillbirth rate, as expected, was high is those who demised (62.5%).We conclude that complications due to hypertension in pregnancy should be considered as a failure to provide quality antenatal care and represent a missed opportunity to detect and treat raised blood pressure.