Obstetrics – Hypertensive Disorders of Pregnancy in NEET PG
Introduction
Hypertensive disorders of pregnancy (HDP) are a critical and high-yield topic in NEET PG, as they account for a significant proportion of maternal and fetal morbidity and mortality. These disorders require precise clinical evaluation, timely diagnosis, and appropriate management to prevent complications such as eclampsia, placental abruption, and preterm birth. NEET PG often tests these topics through scenario-based questions, laboratory interpretation, and management protocols. A systematic understanding of the types, risk factors, and treatment strategies makes this subject approachable and highly scoring for aspirants.
Classification of Hypertensive Disorders
- Gestational hypertension: BP ≥140/90 mmHg after 20 weeks without proteinuria.
- Preeclampsia: Hypertension with proteinuria or organ dysfunction after 20 weeks.
- Eclampsia: Onset of convulsions in a woman with preeclampsia.
- Chronic hypertension: Hypertension diagnosed before pregnancy or before 20 weeks of gestation.
Risk Factors
- First pregnancy (nulliparity) or multiple gestations.
- Pre-existing hypertension, diabetes, or renal disease.
- Family history of preeclampsia or maternal age >35 years.
- Obesity and autoimmune disorders such as lupus.
Clinical Features
- NEET PG: Persistent headache, visual disturbances (blurred vision, scotomata).
- Oedema inthe face, hands, or generalised swelling.
- Epigastric or right upper quadrant pain due to liver involvement.
- Seizures in cases progressing to eclampsia.
Management Strategies
- Mild preeclampsia: Regular monitoring, bed rest, and antihypertensives if BP >150/100 mmHg.
- Severe preeclampsia: Hospitalisation, IV antihypertensives, and magnesium sulfate for seizure prophylaxis.
- Eclampsia: Immediate seizure control with magnesium sulfate, stabilise vitals, and plan delivery.
- Definitive treatment: Delivery of the baby, timing based on maternal and fetal status.
Maternal and Fetal Monitoring
- Regular BP monitoring, urine protein estimation, and lab investigations (liver, renal, and platelet counts).
- Fetal assessment with ultrasound, Doppler studies, and non-stress tests.
- Monitor for complications like HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets).
- Educate mothers about warning signs and early presentation to the hospital.
Conclusion
Hypertensive disorders of pregnancy in NEET PG emphasise both clinical knowledge and prompt decision-making. By systematically identifying risk factors, recognising early signs, and following protocol-based management, candidates can answer scenario-based questions accurately. Mastery of this topic also directly translates to improved patient care, as timely intervention can prevent serious maternal and fetal complications. A structured approach makes HDP a manageable and scoring area in preparation as well as clinical practice.