PP151. Hypertensive complications in pregnancy - Two year study (2008-2009)

Hypertension affects 10% of all pregnancies and accounts for approximately a quarter of all antenatal admissions. Hypertension in pregnancy includes a wide spectrum of conditions, including pre-eclampsia, eclampsia, pre-eclampsia superimposed on chronic hypertension, chronic hypertension, and gestational hypertension. Pregnancies complicated by hypertension are associated with increased risk of adverse fetal, neonatal and maternal outcomes, including preterm birth, fetal growth restriction, perinatal death, acute renal or hepatic failure, ante partum haemorrhage, postpartum haemorrhage and maternal death. Overall pre-eclampsia complicates 5-6% of pregnancies and eclampsia complicates 1-2% of pre-eclamptic pregnancies.

Analysis of the maternal complications (incidence of ICU admissions, preeclampsia/eclampsia, renal or cardiovascular acute dysfunction, HELLP syndrome, placental abruption, maternal death) and fetal/neonatal outcome.

In a retrospective study, from January 2008 to December 2009, all files related with complications of hypertensive disorders, seen in our institution, were analysed. The statistic analysis was based on Excel 2007.

Of 309 cases, 123 patients (40%) were found to have gestational hypertension while 121 (40%) suffer chronic hypertension. Ninety patients (29%) have preeclampsia or eclampsia (4 cases). 22 patients with chronic hypertension had a superimposed preeclampsia. Fetal growth restriction, HELLP syndrome and placental abruption were the obstetric complications in 4%, 1% and 1% of the cases, respectively. Additionally, multiple pregnancy and gestational diabetes were noted in 2.6% and 10.7% of the patients. Delivery route was vaginal in 90 patients while 68.9% underwent caesarean section. 6.5% of the patients were admitted to ICU and no woman has died. Preterm delivery occurred in 26.2% of the cases and 2 interruptions of pregnancy before 24weeks were performed due to maternal complications. Intrauterine fetal demise was recorded in 2 cases on admission.

Women with hypertensive disorders of pregnancy are more likely to have received medical or obstetric interventions such as caesarean section operations. Pregnancies complicated by preeclampsia and eclampsia may be associated with life-threatening complications for both the mother and infant.