Hypertensive Disorders of Pregnancy: Study Reveals Hidden Burden Among Previously Unrecognized Women
Hypertensive disorders of pregnancy (HDP) are the most common cause resulting in significant maternal and perinatal morbidity and mortality. Knowing its impact in apparently low-risk pregnancies would aid in the development of better screening methods for earlier detection and intervention for the maternal and fetal well-being. In this study, the authors analysed and compared the outcome of hypertensive disorders in a cohort of high-risk versus low-risk pregnancies in a tertiary care hospital over a period of 1 year.
This was a retrospective analytical study. Out of 3328 deliveries analysed, 194 cases were diagnosed with hypertensive disorders. They were divided into 2 groups based on the clinical risk stratification from the initial antenatal visit. The outcomes between the two groups were compared.
Of the 194 women detected, 62% belonged to the apparently low-risk group. The low-risk cohort had a higher predisposition of HDP. Late onset pre- eclampsia (79.2%) was more rampant among the low risk cohort than the high risk cohort (64.8%). The incidence of eclampsia observed in low risk group (5.8%) was found to be double that of the high risk. The maternal and neonatal complications among the groups remained the same. This shows that the low risk cohort bears the brunt of disease with minimal strategies to combat the morbidity.
The study analysed the impact on the apparently low risk group who were expected to have an uneventful maternal and perinatal outcome, but in the due course of time developed complications at par with the high risk group. The incidence of HDP is 5.8%. This shows similarity to the incidence reported in several other studies. As per the report of India’s third National Family Health Survey (NFHS-3, 2005- 06), the incidence of preeclampsia and eclampsia might be higher (∼28% and 7.4–11.3% respectively) as compared to its incidence worldwide. This data was based on self-reported symptoms suggestive of HDP by women who had a live birth in the five years preceding the survey. The study noted decreased incidence of Eclampsia (4.6%) when compared to other studies. The various other incidences noted were, 35.7% and 40%. This can be attributed to adequate antenatal follow up in mothers with previous history of preeclampsia or any other high risk, starting of prophylactic aspirin in selected cases, periodic monitoring of growth and dopplers and prompt timing of deliveries. These have lowered the impact of the disease amongst the high risk. This also reflects our prompt health strategies which reach out to people in all the strata of the society ensuring better coverage at grass root level.
Though all pregnancies require intensive monitoring for better maternal and fetal outcomes, this study provided the quantification of the impact faced by the low risk which has occurred in spite of vigilant scrutinization. It reflects the inadequacy of the methods or predictors present at the moment. This in turn calls for a modus operandi to combat and further fathom the magnitude of the disease by extensive researches in this area and the development of earlier predictors and well as interventions.
Source: Fathima and Natarajan / Indian Journal of Obstetrics and Gynecology Research 2026;13(2):281–287
