Abstract

Background: Hypertension in pregnancy is associated with increased incidence of adverse fetal and maternal outcome. The number of women with hypertension predating pregnancy is underestimated. As young women will not check their blood pressure prior to pregnancy, 1^st trimester booking visit is the ideal time to pick up pre gestational hypertension. Pregestational hypertension is considered as chronic hypertension predating pregnancy.

Aim: Aim of the study was to determine the prevalence of pre gestational hypertension among the antenatal women attending a tertiary care center and to assess the associated factors.

Methodology: This was a cross sectional study conducted in SAT hospital, Govt. Medical College Trivandrum for one year. 400 women attending the OP in their first trimester for registration were selected after informed consent.  BP was checked at the first visit. If Blood pressure was high it was rechecked after six hours. Hypertension was diagnosed if systolic BP > 140mmHg and diastolic BP more than 90 mmHg on two occasions.  Socio demographic factors, age, body mass index, family history of hypertension, and history abortion and history of intra uterine death in previous pregnancy noted by a structured questionnaire Statistical tests used were mean, standard deviation, chi square, odds ratio and multivariate analysis on significant variables derived in univariate analysis.

Results: The prevalence of chronic hypertension was 6.8% and main associations were age more than 25 years, body mass index, and Family history of hypertension, history of abortion and history of intrauterine death.

Conclusion: Screening of all pregnant women in first trimester itself for hypertension will help in early detection of chronic hypertension in pregnancy so that proper investigations and management can be started at the earliest.

Keywords: Pregestational hypertension, Essential hypertension, gestational hypertension.

1.      Hypertension in pregnancy;Preexisting hypertension in pregnancy; Ellen Knox, Mark Kilby, LouiceC. Kenny; chapter5 ; page 63-75

2.      Robert N Taylor; James M Roberts; F Gary Cunningham; Marshall D Lindhei-mer Chesley's hypertensive disorders in pregnancy. Chapter 19.

3.      Kate Bramham, , Bethany Parnell,   Catherine Nelson-PiercyPaul T Seed,   Lucilla Poston, Lucy C Chappell,  Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis: BMJ. 2014; 348: 2301.

4.      ACOG Practice Bulletin No. 29: Chronic Hypertension in PregnancyObstetrics & Gynecology: July 2001 - Volume 98 - Issue 1 - p 177–185.

5.      bScott R. Yoder, MD, Loralei L. Thornburg, MD ,John D. Bisognano Hypertension in Pregnancy and Women of Childbearing Age October 2009Volume 122, Issue 10, Pages 890– 895

6.      Bharti Mehta, Vijay Kumar, Sumit Chawla, Sandeep Sachdeva ,Debjyoti Mahopatra Hypertension in pregnancy: A community-based study; Indian Journal Community Medicine.|  Volume : 40  |  Issue : 4  Oct-Dec. 2015 Page :273-278

7.      Ellen W. Seely, Jeffrey Ecker; Cardiovascular Management In Pregnancy Chronic Hypertension in Pregnancy Circulation. 2014;129:1254-1261.

8.      Robert A. Gold a,⇑ , Kellyanne R. Gold a , Mark F. Schilling b , Tamara Modilevsky ; Effect of age, parity, and race on the incidence of pregnancy associated hypertension and eclampsia in the United States a Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 4 (2014) 46–53 .

9.      Sibai, Baha M. MD  Obstetrics& Gynecology:High-Risk Pregnancy Series: An Expert's Viewchronic Hypertension in PregnancyAugust 2002 - Volume 100 - Issue 2 - p 369–377.

10.  Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle-aged women and men: the Framingham Heart Study.JAMA. 2002;287(10):1003–1010..

11. Xu Xiong, MD, DrPHa, William D. Fraser,  MDa,  Nestor N. Demianc-zuk, MDbHistory of abortion, preterm, term birth, and risk of preeclampsia: A population-based study American Journal of Obstetrics and Gynaecology Volume 187,Issue 4,October2002,pages 1013 -!018.