Frequency of Preeclampsia in Pregnant Women Presenting in A Tertiary Hospital

Preeclampsia is pregnancy speci�c disorder that involves endothelial dysfunction and vasospam, so it needs prompt diagnosis and expert management as both mother and fetus are at risk. Objective: To determine the frequency of preeclampsia in pregnant women presenting in a tertiary hospital. Methods: This Cross-Sectional study was done in Department of Obstetrics and Gynecology, Unit-II ward-9, Jinnah Postgraduate Medical Centre, Karachi from th th 6 April 2018-10 November 2018. We included 340 pregnant females ful�lling the inclusion criteria. Informed consent was taken. The data were collected on prepared performa. Results: A total of 340 pregnant women were included in this study, mean age of patients was 28.3 ± 3.5 (16-30) years and mean gestational age in patients was 33.6 ± 5.2 in weeks. 49(14.4%) patients had pre-eclampsia while 291(85.6%) pregnant women were normotensive. Conclusions: Our results show patient with preeclampsia are at increased risk for morbidity and mortality of both new born and mother, so proper antenatal workup is required.

function indicated by elevated liver enzymes, progressive r e n a l i n s u c i e n c y , p u l m o n a r y e d e m a a n d thrombocytopenia [2].Proteinuria is de ned as presence of at least 300mg of protein in 24-hour urine collection.Preeclampsia is characterized by endothelial dysfunction so it usually leads to multisystem disorder [3,4].It may involve cardiovascular system resulting in to hypertension, may lead to thromboembolism may present with deep venous thrombosis or stroke.Although hypertension is the most common presentation.Number of maternal and fetal risk factors are involved in the pathophysiology of preeclampsia like prim paternity, limited sperm exposure,

I N T R O D U C T I O N
Preeclampsia is pregnancy speci c disorder that involves endothelial dysfunction and vasospam, so it needs prompt diagnosis and expert management as both mother and fetus are at risk.Objective: To determine the frequency of preeclampsia in pregnant women presenting in a tertiary hospital.Methods: This Cross-Sectional study was done in Department of Obstetrics and Gynecology, Unit-II ward-9, Jinnah Postgraduate Medical Centre, Karachi from th th 6 April 2018-10 November 2018.We included 340 pregnant females ful lling the inclusion criteria.Informed consent was taken.The data were collected on prepared performa.Results: A total of 340 pregnant women were included in this study, mean age of patients was 28.3 ± 3.5 (16-30) years and mean gestational age in patients was 33.6 ± 5.2 in weeks.49(14.4%)patients had pre-eclampsia while 291(85.6%)pregnant women were normotensive.Conclusions: Our results show patient with preeclampsia are at increased risk for morbidity and mortality of both new born and mother, so proper antenatal workup is required.

R E S U L T S
A total of 340 pregnant women were included in this study, mean age of patients was 28.3 ± 3.5 (16-30) years.Mean BMI of the patients was 25.4 ± 4.1, mean gestational age in patients was 33.6±5.2 in weeks as shown in table 1.A major pregnancy condition known as preeclampsia (multisystem illness) typically develops after 20 weeks of pregnancy.Preeclampsia affects 3-8% of pregnant women and accounts for 20% of maternal deaths, preterm birth and perinatal mortality each year worldwide.In the UK, it makes about 4-6% of pregnancies more di cult.The third most common cause of maternal death and morbidity in the world is preeclampsia [6].The World Health Organization (WHO) has estimated that preeclampsia kills over 60,000 women worldwide year, accounting for 11% of deaths in the United Kingdom and 24% of all maternal deaths in India.The strongest risk factor for preeclampsia in subsequent pregnancies is the rst pregnancy, where the chance of preeclampsia is 4.1% [7,8].Preeclampsia recurrence rates have been reported to range considerably from 0-5% and even up to 65%.Preeclampsia's pathogenesis is still mostly unclear.It has been proposed that maternal endothelial dysfunction, which manifests clinically as hypertension, proteinuria, and edoema, is caused by a soluble substance or components that are reduced by placental synthesis as a result of early placental ischemia.Pregnancy delivery is the only treatment for pre-eclampsia, however the choice of whether to monitor the mother or deliver the baby is crucial for both the mother's and the fetus's welfare.Antiplatelet aspirin therapy, which lowers the incidence of pre-eclampsia by 10% in women who have at least one risk factor, is the foundation of secondary prevention [9].There is presently no study that can be used to determine the precise dosage or the ideal timing to start taking aspirin.However aspirin should be started as soon as feasible, i.e., before 12-14 weeks, which corresponds to the start of the trophoblast invasion's rst phase.Aspirin's effectiveness has only been demonstrated in women who had pre-eclampsia in the past that was accompanied by intrauterine growth retardation and who were thrombophilic-free [10,11].In this study mean age of patients was 28.3 ± 3. gures from china and japan up to 0.59% lies closer to lower value one reason of higher number in developing countries like us might be lower concern about health and lack of facilities [17].In this study preeclampsia was more observed in patients with diabetes mellitus vs non-diabetic (59.1% vs 40.8%) with signi cant p-value, this may be diabetic patients more prone to develop endothelial dysfunction, similar nding was also observed in other studies where diabetes was strong risk factor for preeclampsia [18,19].We have also observed that preeclampsia was more in women with rural background vs urban (57.1% vs 42.8%) was statically insigni cant similarly study by Moussa et al., was also supportive to these ndings [20].
The study gives new insight of increasing trend in pre-eclampsia over the years that needs proper understanding of pathophysiology and major risk factors for the development of preeclampsia.This study also warns for antenatal checkup as there was more preeclampsia as obser ved in patients with rural background.More studies are suggested in future for much better understanding.

Table 1 :
Descriptive Statistics of Demographic Characteristics

Table 2 :
Descriptive statistics of clinical characteristics

Table 3 :
Strati cation for pre-eclampsia with variable