Hypertensive disorders in pregnancy at the federal medical centre, Yenagoa, South-South Nigeria: a 5 year review

Abstract

Background: Hypertensive disorders complicate 5.2%-8.2% of pregnancies, and contribute significantly to perinatal and maternal morbidity and mortality worldwide. To determine the incidence, clinical characteristics, maternal and perinatal outcomes of hypertensive disorders in pregnancy at the Federal medical centre, Yenagoa, Bayelsa State, South-South Nigeria.Methods: This retrospective study was conducted between 1 January, 2016 and 31 December, 2020. Relevant data was retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0.Results: Out of the 4,571 obstetric patients that were managed in our Centre in the period under review, 335 of them had HDP, giving an incidence rate of 7.32%.The most common HDP were pre-eclampsia (189, 56.4%) and eclampsia (82, 24.5%), while the least common was chronic hypertension (3, 0.9%). A little more than one-half (171, 51.0%) of the women delivered preterm, with a mean gestational age at delivery of 35.5 weeks. The most common route of delivery was emergency Caesarean section (205, 61.2%). There were three maternal deaths, giving a case fatality rate of 0.9%. Two of the maternal deaths were due to eclampsia, and one, from pre-eclampsia.Conclusions: Women should be adequately counseled to embrace preconception care, and early and regular antenatal care visits, with proper monitoring of blood pressure and urine protein. Prompt diagnosis and management are key in preventing the maternal and perinatal morbidity and mortality that are associated with these disorders.

Eclampsia Managed at Nnamdi Azikiwe University Teaching Hospital (NAUTH), NNEWI, South-East Nigeria: A 5-Year Retrospective Cross-Sectional Studya

“…The majority of the women in our study were delivered preterm, which may have contributed to the high rate of prematurity and requirement for SCBU. This is consistent with research showing an increased risk of iatrogenic preterm birth in pregnant women with hypertensive Disorders of Pregnancy [16,26].…”

“…The majority (95%) of the eclamptic patients in this study were unbooked; similar findings have been found in investigations from other parts of the nation [12,14,16]. But a small percentage of the women (5%) were booked.…”

“…This study revealed an eclampsia prevalence rate of 1.65%. This is similar to the findings of 1.67% by Osazee et al in Benin [14], but lower than the finding of Onyekpa in Enugu [15], and higher than the findings of 0.97% by Adelola e tal in Sagamu [12], Oriji in Yenogoa [16] and Geidam [17]. This can be attributed to late referral of Preeclamptic/eclamptic cases for expert management by caregivers in nearby primary and secondary health facilities especially after progression to eclampsia.…”

“…In this study, antepartum eclampsia was the most typical clinical form of the condition. Similar investigations have been conducted in the nation and other developing nations [12,14,16,18]. This is not unexpected for a low and middle-income nation like Nigeria, where healthcare utilisation is low and prenatal care and birth outcomes have not been optimal.…”

Blood reservation and utilisation practice for Caesarean section in Ilorin, Nigeria

“…19 HDP may be complicated by coagulopathy, which is a risk factor for PPH. 20 These may have contributed to the high blood utilisation in these conditions in our study.…”