Pune: The leading causes of maternal mortality in India are haemorrhage, sepsis, abortions, hypertensive disorders, obstructed labour and medical conditions such as anaemia.1 While deaths from haemorrhage and infections have declined in recent years, there has been a rise in the number of deaths associated with hypertension during pregnancy. Although the reason why some women experience elevated blood pressure levels during pregnancy is not fully understood, hypertension remains one of the most common medical conditions during pregnancy.2
Hypertension during pregnancy also called gestational hypertension, prevents the placenta from receiving sufficient blood supply. When the placenta is deprived of blood, the growing baby receives less oxygen and nutrients. This in turn causes a number of birth-related complications such as low birth weight and premature birth. Other complications include learning disabilities, epilepsy, cerebral palsy, hearing and vision problems as long term complications of premature birth and growth restriction. Moreover, maternal hypertension also increases the risk of congenital heart disease in the foetus3, a condition where structural problems in the heart are present at birth.
In India, the prevalence of hypertensive disorders in pregnancy is about 6-8%1, which means that at least 6 in every 100 women experience elevated blood pressure levels during pregnancy. In some cases, women suffer from hypertension before pregnancy, while in others, the condition develops during pregnancy.
Dr Manjiri Kulkarni, Medical Director, Cloudnine Group of Hospitals, Shivajinagar, Pune explains, “Hypertension in pregnancy can lead to a serious condition called preeclampsia, characterized by high blood pressure, excessive excretion of protein in the urine and swelling in the feet, legs and hands. The condition usually appears late in pregnancy, generally after the 20-week mark. If left undiagnosed, preeclampsia can lead to eclampsia, a serious condition that puts both mother and baby at risk, and in rare cases may even cause death.”
Fortunately, most women can deliver a healthy baby if gestational hypertension is diagnosed and treated early during pregnancy. It is now also possible to prenatally identify major structural congenital heart defects if any, which enables parents to be better prepared before the baby is born and to choose a healthcare facility that is equipped to manage such a delivery. It is also imperative that such newborns be screened for any critical congenital defects after birth.
On occasion of World Heart Day, doctors urge patients to be more aware of the condition and seek prompt medical attention if they suspect gestational hypertension. This will, in turn, significantly help improve pregnancy outcomes and reduce the high rates of morbidity associated with the condition.
Effect of Heart Disease on Pregnancy4
• Intrauterine growth retardation • Premature labour • Still birth • Abortion
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