Comparison of patients presenting with hypertensive disorders of pregnancy antenatally versus de-novo postpartum hypertension.

INTRODUCTION

To describe the characteristics of patient's presenting with postpartum hypertension, comparing those with known hypertensive disorders of pregnancy (HDP) antenatally to patients presenting with de novo postpartum hypertension.

METHODS

A retrospective audit of deliveries at Northern Health from January 2016 to December 2020. International Classification of Diseases (ICD) codes combined with a manual medical records search identified 72 records that resulted in representation to hospital with hypertension. Data was collected to observe and compare maternal, pregnancy and fetal characteristics.

RESULTS

Of the 72 patients, 35 (48.6 %) readmissions had known HDP and 37 (51.4 %) had de novo postpartum HDP. Similarities were observed between both the patients with known HDP and de novo postpartum hypertension group, including maternal age at delivery (32.4 ± 4.9, 31.9 ± 5.6 years), BMI (32 (25-38), 31 (24-41) kg/m2) and nulliparity (48.6 %, 40.5 %). Aspirin prescription was similar in both groups (28.6 %, 27.0 %). The mean birthweight of the known HDP group was significantly less (2893.7 ± 231.4 g) compared to the de novo group (3362.4 ± 584.4 g). Differences were observed in the urine protein to creatinine ratio (uPCr) antenatally. Antenatally and postpartum the blood pressure readings for the known HDP were significantly higher than the de novo group.

CONCLUSIONS

More than 50 % of patients representing are de novo HDP. It does not appear pre-eclampsia is unrecognised antenatally in the de novo group. Our study does not highlight key factors that aid the recognition of those at risk of developing postpartum hypertension separate to the risk factors that are associated with HDP generally.