HYPERTENSIVE DISORDERS IN DIABETIC PREGNANCIES- EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN KERALA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 9
Abstract
BACKGROUND Hypertensive disorders of pregnancy complicate 5-10% of all pregnancies. Pre-eclampsia and eclampsia are leading threats to safe motherhood in developing countries. Studies showing the association between hypertensive disorders of pregnancy and diabetes are generally based on data from western settings. The main objective of the present study is to find out as to whether the proportion of hypertensive disorders in diabetic pregnancies is more compered to euglycemic patents in a tertiary care hospital in Kerala. MATERIALS AND METHODS A prospective observational study was conducted among antenatal women diagnosed to have diabetes (GDM/overt) who received antepartum care at Govt. Medical College Kottayam. The controls were matched normoglycemic patients. Information was collected using questionnaires. BP was measured using standard methods with Korotkoff 1 for systolic BP and Korotkoff 5 for diastolic BP. BP more than 140/90 on two occasions six hours apart was taken as hypertension. For detecting diabetes, IADPSG values of fasting 92 mg/dl (>5.2 mmol /l), 1 hr. 150 mg/dl (>10.0 mmol/l) and 2 hrs. 153 mg/dl (8.5 mmol/l) were taken. RESULTS Of the 241 patients, majority belong to the age group 21-30 (83%). 56.5% were primigravidas. Diabetic pregnant ladies are more prone to develop hypertensive disorders of pregnancy (21.4%) as compared to nondiabetics (12.1%). Of the diabetics, majority 94 (87.8%) belongs to GDM group and 13 (12.2%) were overt DM. Out of the 214 (16.8%) developed hypertensive disorders of pregnancy. Among the diabetic patients those with overt DM are at a higher risk of developing hypertensive disorders (38.4% with overt DM and 19.1% of GDM). In the GDM group, 11.7% developed gestational hypertension, 5.3% preeclampsia and 2.1% eclampsia. Among overt diabetics, 38% developed preeclampsia. There were no cases of gestational hypertension or eclampsia among overt DM patients. 60% of diabetics who developed hypertension had poor glycaemic control which shows that glycaemic control had a strict relation with development of hypertension in diabetic patients. CONCLUSION There was increased incidence of hypertensive disorders of pregnancy in diabetic patients compared to nondiabetic controls in our setting also. Those with poor glycaemic control are at increased risk of developing hypertension.
Authors and Affiliations
Coockoo Lal, Asha Gopi Nath
Keywords
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- EP ID EP555091
- DOI 10.14260/jemds/2019/126
- Views 92
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