Neonatology

Biography

Biography: Shakuntala Chhabra

Abstract

Hypertensive disorders during pregnancy, labour (HDsP), dangerous disorders with persisting dilemmas, affect perinatal survival because of many reasons including gestation, and interventions done. In a recent study of 1046 cases of HDPs (11.73% of 8920 births), mean gestation at birth in early onset (EO) HDsP category A cases (>20 + <28 weeks pregnancy) was 30+1 weeks, B EO(>28 - <34 weeks) 32+6 weeks, C LO(>34-<37 weeks) 35+4 weeks and D LO(>37 weeks) 38+4 weeks. In category A preterm births were 97.5%, caesarean section rate 42.5%, category B, preterm births 84.29%, CSR 53.93%, category C, preterm births 31.37%, CSR 40.63%, category D, CSR 46%. Mean birth weight in category A was 1741.54 gms, B 1936.31 gms, C 2633.38 gms and D 2677.30 gms. Perinatal deaths in category A were 45%, (100% perinatal deaths in births before 28 weeks, 100% survival if reached term but only 2), B 25.13%, C 14.32%, D 14.00%. Critical gestation was 32 weeks plus. Around 34 weeks survival was similar to term. In our other study of HDsP, in cases with complete HELLP (Haemolysis, elevated liver enzymes Low platelets) or partial HELLP perinatal mortality rate was 275, overall in HDPs 150, in HDPs without HELLP it was 110. Overall PMR during same period was 50. In Eclampsia cases when conservatism was tried in cases of <32 weeks pregnancy, of 33(8%) cases, 14 intra uterus deaths, 1 fresh still birth + 3 neonatal deaths occurred. Mothers remained healthy. Babies birth weight got affected by premurity and dysmaturity affecting survival. In other study of HDsP lipid glucose metabolism affected birth weight. Calcium, vitamin C, E for prevention of HDsP in high risk cases continues to be controversial. Aspirin helps, controversy is when to start. Low-molecular-weight heparin has been studied with no effect on onset, severity. More research is needed.