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Management and perinatal outcomes of hypertensive disorders of pregnancy in a low-resource setting in Indonesia

Tjandraprawira, KD; Kusumah, AY; Kamilah, AY; Putri, DI; Ananta, MR; Sari, SP; Djuwantono, T; (2021) Management and perinatal outcomes of hypertensive disorders of pregnancy in a low-resource setting in Indonesia. SAGE Open Medicine , 9 10.1177/20503121211060194. Green open access

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Abstract

Objectives: To provide up-to-date data concerning hypertensive disorders of pregnancy on maternal and neonatal profiles in Indonesia. Methods: Retrospective clinical audit on all pregnancy-associated hypertensive women between 1 January 2020 and 31 March 2020 at Cianjur General District Hospital. Results: Preeclampsia accounts for 66.8% (235/352) of hypertensive disorders of pregnancy, gestational hypertension 29% (102/352) and chronic hypertension 4.3% (15/352). Compared to other pregnant women, those with preeclampsia, on average, had higher systolic and diastolic blood pressures and poorer kidney (ureum and creatinine) and liver function (aspartate transaminase enzyme and alanine transaminase enzyme) profiles (p < 0.001, < 0.001, < 0.001, 0.003, 0.033 and 0.002, respectively), and required more intensive care admission. Neonates from women with severe forms of preeclampsia (eclampsia and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets)) had, on average, lower birthweight (p = 0.015 and 0.048, respectively) and birth length (p = 0.021, 0.017). Neonates from eclamptic mothers had poorer APGAR (appearance, pulse, grimace, activity and respiration) scores (p = 0.006 and 0.005, respectively). Conclusion: Hypertensive disorders of pregnancy exerts adverse maternal and neonatal outcomes, particularly among eclampsia and HELLP-syndrome neonates. Various challenges remain for optimal management.

Type: Article
Title: Management and perinatal outcomes of hypertensive disorders of pregnancy in a low-resource setting in Indonesia
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/20503121211060194
Publisher version: https://doi.org/10.1177/20503121211060194
Language: English
Additional information: © The Author(s) 2021. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Keywords: Hypertensive disorders of pregnancy, adverse maternal outcomes, adverse neonatal outcomes, eclampsia, preeclampsia
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10175606
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