Multiple pregnancies and gestational hypertensive diseases

Abstract

Objectives: To evaluate the incidence of gestational hypertensive diseasesin multiple pregnancies and the relationship between the type of chorionicityand severity of the presentation of the hypertensive disorder in comparison with single pregnancies.Methods: A retrospective study was carried out in all women who attended their multiple pregnancy at the Hospital Posadas during 2012, 2014 and 2016. Type of pregnancy, birth weight, gestational age, intrauterine growth retardation, mortality, and Uricemia ratio (uricemia after 20th week /uricemia before 20th week).Results: 180 multiple gestations were analyzed, and 362 newborns were studied. Among them 9% were monochorionic monoamniotic, 37% were monochorionic diamniotic, and 54% were dichorionic diamniotic. Multiple pregnancies presented more risk of prematurity, lower birth weight and higher mortality than single pregnancies. The relative risk of developing a gestational hypertensive disease was 1.47 (1.01-2.19). Although the monochorionic monoamniotic group reaches the highest percentage of term birth, it has an increased risk of developing a gestational hypertensive disease, fetal growth restriction, and mortality. Regarding uric acid levels, it was observed that the behavior of the uricemia ratio was similar in normotensive women with simple and multiple pregnancies (1.20±0.29 vs 1.30±0.07) and in simple and multiple pregnancies associated to a hypertensive disorder such as preeclampsia (1.57±0.13 vs 1.73±0.13) orgestational hypertension (1.42±0.24 vs 1.3±0.09).Conclusion: Our results showed no difference in the severity of the presentationof the hypertensive disorder between multiple and single pregnancies, revealing a similar maternal systemic dysfunction between both groups.