MANAGEMENT OF HYPERTENSIVE DISORDERS OF PREGNANCY A RETROSPECTIVE COMPARATIVE STUDY
Desard Hashorva, Eva Duraku (Muja) MD, PhD, and Eduart Hashorva MD, PhD
ABSTRACT
Background: Hypertensive disorders of pregnancy (HDP) is one of the most important reasons for neonatal and maternal morbidity and mortality worldwide. This is the rationale for setting up the optimal available management protocols, especially at the tertiary level. Objective: The study was carried out to compare drug and clinical management trends of HDP in two consecutive years (2023–2024) in the "Queen Geraldine" Obstetrics & Gynecology University Hospital in Tirana, Albania. Methods: Retrospective comparative observational study on the basis of hospital and clinical records of 2023 and 2024. Data included are type and frequency of antihypertensive medications, time of delivery (preterm vs. term), and type of delivery (cesarean section vs. vaginal). Descriptive statistics and inferential tests (t-tests, chi-square) were utilized on SPSS v22 with the significance level of p < 0.05. Results: 217 HDP cases were examined (104 in 2023 and 113 in 2024). Methyldopa and Nifedipine were the most common medications used both years. The study finds that MgSO₄ was used more in 2024 (17% in 2023 vs. 24% in 2024; p = 0.04), which is an obvious indication of increased compliance with seizure prophylaxis guidelines. the most frequent mode of delivery for HDP cases Cesarean section remained (82% in 2023; 79% in 2024), although the drop was not statistically significant (p = 0.19). Premature delivery remained high (42% in 2023; 37% in 2024), representing the continued equipoising challenge between maternal and fetal risks in HDP. Conclusions: High prescription rates of Methyldopa and Nifedipine reinforce their status as first-line therapy in the management of HDP. Growth in the use of MgSO₄ is indicative of more guideline adherence. Though decreased, cesarean delivery is still the most prevalent method of delivery. These findings are a testament to the need for further optimization of guidelines for the treatment of HDP and unnecessary cesarean births with improved perinatal results.
Keywords: Hypertensive pregnancy disorders; Antihypertensive medication; Cesarean delivery; Average hospital length of stay; Maternal outcomes.
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