Prevalence and Outcomes of Gestational Hypertension and Its Progression to Eclampsia: A Tertiary Care Perspective

Abstract

Gestational hypertension remains one of the most frequent hypertensive disorders in pregnancy, contributing significantly to maternal and perinatal morbidity. Progression to preeclampsia or eclampsia increases the risk of adverse outcomes, including placental insufficiency, multi-organ dysfunction, and neonatal complications. This study investigates the prevalence patterns, clinical characteristics, and maternal–fetal outcomes associated with gestational hypertension in a tertiary care setting. A retrospective observational design was used to analyze antenatal records, laboratory parameters, and outcome indicators among pregnant women diagnosed with gestational hypertension over a three-year period. The analysis focused on disease progression, risk factors, severity indicators, and the spectrum of maternal and perinatal complications. Findings reveal that 27.4 percent of women with gestational hypertension progressed to preeclampsia, and 6.2 percent developed eclampsia, with higher incidence among primigravida and women with elevated BMI. Severe hypertension, proteinuria, abnormal liver enzymes, and fetal growth restriction were key predictors of progression. Maternal complications included HELLP syndrome, acute kidney injury, and postpartum hypertension, while neonatal outcomes included preterm birth, low birth weight, and NICU admission. Results underscore the need for earlier detection, closer monitoring, and standardized clinical management algorithms in tertiary institutions. The study highlights critical areas for policy strengthening and improved antenatal surveillance in resource-constrained settings.