Pregnancy Induced Hypertension Led ‘Hellp Syndrome’ Dueto Medication Non Adherence: A Case Report Establishing the Importance of Antenatal Clinic Care

Abstract

Background: This case report aims to highlight the significance of Medication adherence in Pregnant women, especially with Pre-existing Gestational Hypertension or Gestational Diabetes Mellitus.

Case Presentation: A twenty-two-year-old female patient with an obstetric history of Primigravida with thirty weeks and three days of Period of gestation came with a referral letter stating “BP – 170/100 mmHg Capsule Nifedipine long stat”. The patient came up with the complaint of one episode of vomiting in the morning followed by epigastric pain along with bilateral Grade Two Pedal edema. The patient was diagnosed with Severe Pre-eclampsia with Hemolysiselevated liver enzymes-low platelet syndrome with intra-uterine growth restriction

Discussion: In this case, the Patient had a perception that the signs of pedal edema would gradually subside with self-care. Due to non-adherence to the antihypertensive drugs, minor complaints of the patient eventually lead to severe Pre-eclampsia leading to HELLP syndrome and other gestational complications such as Placental insufficiency, fetal growth restriction. Uncontrolled HTN affects kidney blood vessels & and weakens them causing no reabsorption of the proteins.

Conclusion: This case highlights the need for the establishment of a clinic where “Assessment of drug-related problems in pregnant women is conducted and Antenatal patient care including medication education, lifestyle modifications are provided lead by clinical pharmacist” in every Primary & tertiary health care hospital.