Prevalence of pregnancy induced hypertension and pregnancy outcomes among women seeking maternity services in Harare, Zimbabwe

Abstract

BackgroundPregnancy induced hypertension (PIH) is one of the most common causes of both maternal and neonatal morbidity, affecting about 5 – 8 % of pregnant women. It is associated with adverse pregnancy outcomes as well as maternal morbidity and mortality. Harare City experienced an increase in referrals due to PIH to central hospitals from 2009 to 2011. We conducted a study to determine the prevalence of PIH and pregnancy outcomes among women with PIH.MethodsAn analytic cross sectional study was conducted. Interviewer administered questionnaires were used to capture demographic data, obstetric history and knowledge on PIH management. Records were reviewed for pregnancy outcomes while key informants were also interviewed on patient management.ResultsPIH prevalence was 19.4 %. Women with PIH were three times more likely to deliver a low birth weight baby (OR 3.00, p = 0.0115), 4.3 times more likely to have still birth (OR 4.34, p = 0.0517) and four times more likely to have a baby with low Apgar score at 5 minutes (OR 4.47, p = 0.0155) compared to women without PIH. There was no statistically significant difference in delivery before 37 weeks gestation between women with PIH and those without (OR 1.70, p = 0.1251). 12,5 % of the women delivered by caesarean section. Methyldopa was the drug of choice for management of PIH. Less than half of the health workers had sufficient knowledge on definition or management of PIH. Delay in seeking care and shortage of resources were the major reported challenges in the proper management of PIH.ConclusionPIH prevalence was high. Women with PIH were at higher risk of adverse pregnancy outcomes than those without. Poor knowledge of management of PIH and inadequate resources are a threat to the proper management of PIH. This underscores the need for increased human resources and capacity building as well as resource mobilisation for proper management of pregnant women. Urinalysis must be routinely done for all pregnant women regardless of their blood pressure.

Incidence of gestational hypertension among pregnant women (2006-2015) in Enugu State, Southeast Nigeria: a retrospective study

“…2,7,15 However, the finding of the study was not comparable with what had been reported by and who reported much higher incidence, although for their respective countries. 18,22,29 The finding of a much lower incidence of GHTN in Nigeria compared to what had been reported by almost a decade ago, could reflect an improvement in antenatal services that has occurred in the country over the years. 22 In addition, this could also reflect regional differences in the incidence of GHTN, as conducted their own study in South-south Nigeria, whereas the present study was conducted in Southeast Nigeria.…”

“…For instance, in Karachi, reported an incidence of 37%, while found 19.4% in Zimbabwe. 18,29 In Nigeria, found an incidence of 20.8%. 22 On the average, an incidence of 6-7% of GHTN has been reported globally.…”

“…3,10,14 Worldwide, 4.4% -15% of all pregnancies are complicated by hypertension (HTN). 6,7,[15][16][17][18] In Nigeria, prevalence rates of hypertensive disorders of pregnancy range from 17% to 34.1%. [19][20][21] Studies solely dedicated to GHTN appear not to be available.…”

Nutritional Status of Pregnant Women and Urine Calcium-to-Creatinine Ratio During 24th - 28th Weeks of Pregnancy and Their Relationship with the Incidence of Hypertensive Disorders During Pregnancy

“…Urine calcium can be used as a predictive marker for the diagnosis of preeclampsia. Severe morbidity and mortality associated with preeclampsia or eclampsia in the developed countries have been substantially reduced, but they are still a serious and dangerous problem that threatens a safe motherhood particularly in developing countries (2,13). With that in mind, it is important to know the factors that are associated with these disorders and that careful care and treatment of the disease are necessary.…”

“…These changes may cause hypertension in people with a history of high blood pressure. The mechanism is though still unknown (1,2). Hypertensive disorders are the most common health complications of pregnancy that occur in 5% to 10% of all pregnancies (3).…”