COMPARISON OF EXPECTANT MANAGEMENT VERSUS INDUCTION OF LABOUR FOR MILD HYPERTENSION OF PREGNANCY AT 37 WEEKS GESTATION: A RANDOMIZED CONTROL TRIAL
NISHA SINGH
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, India
MEENAKSHI JOHRI
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, India
NAMRATA KASHYAP *
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, India
UMA SINGH
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, India
*Author to whom correspondence should be addressed.
Abstract
Aims and Objectives: To compare the fetomaternal outcome of expectant management and induction of labour at 37 weeks in women with non severe Preeclampsia and mild Gestational hypertension.
Materials and Methods: Total 140 women with Mild preclampsia or gestational hypertension were recruited at 37 weeks after informed consent and randomly divided to Group I (70) and Group II (70). Group I women were monitored till spontaneous labour or 40 weeks. Group II women underwent induction of labour. The results were statistically analysed to compare the progression to severe disease, mode of delivery and neonatal unit admissions.
Results: A total of 5.7% of Group I women developed severe hypertension and none in Group II. No other complications of hypertension were seen in any group. The incidence of caesarean delivery in group I and group II was comparable (p=0.733). Cesarean rates were comparable among women taking antihypertensive and not taking antihypertensive drugs (p=0.165). The most common indication for caesarean was thick meconium stained liquor (18.6% & 21.4%) in both groups. Incidence of low APGAR score (p=0.706) and neonatal unit admission (p=0.245) were comparable in both groups.
Conclusion: There is no difference in fetomaternal outcome of women with mild gestational hypertension and non severe preeclampsia managed by either induction of labour or expectant management after 37 weeks gestation. Thus, they may be offered induction of labour to eliminate any risk of progression to severe disease.
Keywords: Preeclampsia, non severe preeclampsia, gestational hypertension, induction, labor, hypertension