Perinatal Outcomes in Women with History of Chronic Hypertension but Controlled Blood Pressure Before 20 Weeks Gestation

Abstract

Objective: To determine the perinatal outcome in women with prior history of chronic hypertension but controlled BP before 20 weeks of gestation. Methodology: A descriptive cross-sectional study was conducted at the Department of Gynaecology, Sheikh Zayed Medical College, Rahim Yar Khan, from November 2019, to May 2020, on patients aged 20 to 40 years old with singleton pregnancy of 20 weeks or more with previous history of hypertension but currently on no treatment for last one month or more and with normal blood pressure irrespective of parity. After taking demographic and clinical information the patients were followed every month to look for small for gestational age (SGA), pre-eclampsia and pre-term birth. Data was entered and analysed using SPSS-version 26.0. Results: Overall mean age was 28.1 ± 3.2 years. Out of all cases, 22% had fetuses small for gestational age, 21% developed pre-eclampsia, and 23% had urinary protein levels below 300 mg/24 hours, while 77% had raised levels. FSGA was most common at ages 26–30 (50%) and pre-eclampsia at 31–40 years (41.9%), both significantly associated with age and parity (p=0.031, p=0.0497), but not with previous cesarean (p>0.05). Preterm birth was more frequent in ages 26–40 and higher parity, while statistically insignificant (p>0.05). Conclusion: Women with a history of chronic hypertension, even when blood pressure is controlled before 20 weeks of gestation, remain at increased risk for adverse perinatal outcomes