Abstract
Several risk factors including hypertension are common complications of pregnancy with preeclampsia particularly associated with substantial risk to both the mother and fetus. This cross-sectional study involving quantitative approach was conducted in Same District Hospital in Tanzania. Data were collected from all pregnant women in the hospital using questionnaires. Respondents’ knowledge on maternal mortality regarding preeclampsia included those who had no knowledge 60(60%), and those who had knowledge 40(40%). Most of the respondents had no knowledge of maternal mortality due to the complications of preeclampsia. The study revealed that 64(64%), had positive attitude towards maternal mortality due to preeclampsia prevention while 36(36%) had no response. About 68(68%) of the respondents could not access the health facilities saying that these health facilities were not affordable citing that the distance was too long. They reported no health facilities and services as well as insecurity while looking for health facilities/services and finally that there were few health workers in the health facilities meaning that patients could not be attended to on time. Furthermore, health workers harassed the patients and make them seek other alternatives when they are sick, while minority 32(32%) said that the health facilities were accessible, affordable and efficient. Medical history during prenatal care showed that 25% of the respondent had increased blood pressure more than 140/90 mmHg, but only 10% had breath issues. Laboratory diagnosis of the respondents revealed increased proteinuria (48%) and impaired liver function (7%). Respondents experienced 39% convulsion and 24% pulmonary edema. Overall, the study identified a few predisposing factors to preeclampsia/eclampsia among pregnant women. Also, most of the respondents were said to have no knowledge of eclampsia thereby increasing maternal mortality. Key words: Preeclampsia, hemolytic elevated liver enzymes, eclampsia, low platelet count, disseminated intravascular coagulopathy, intrauterine growth restriction, intrauterine fetal death, pregnancy induced hypertension.
Highlights
Hypertension is a common complication of pregnancy
In African countries such as South Africa, Egypt, Ethiopia and Tanzania, the rates of preeclampsia have been reported to vary from 1.8% to 7.1% (Osungbade and Ige, 2011).PIH is defined as systolic blood pressure (SBP) > 140 mmHg and diastolic blood pressure (DBP) > 90 mmHg
Percentage 39 24 20 17 100 between 45-49 (16%), while the young mothers most of the age 15-24 (12%).This shows that most of the respondents, who were in the reproductive stage of life were much more exposed to preeclampsia than any other group (Hollegaard et al, 2013).there is need to further educate patients about preeclampsia/eclampsia to decrease adverse outcomes associated with this condition (You et al, 2012a, b)
Summary
Hypertension is a common complication of pregnancy. Preeclampsia, in particular, is associated with substantial risk to both the mother and the fetus. Pregnancy induced hypertension (PIH) is classified according to the severity of hypertension. The Japan society of hypertension made practice guidelines in 2014, and the Japan Society for the study of hypertension in pregnancy made its guidelines subsequently in 2015. Both guidelines stated that the basic treatment for PIH is the interruption of pregnancy, and antihypertensive therapy should be given for protection in the mother complicated by severe hypertension (Suzuki et al, 2015). The fetal heart rates should be monitored enough due to worsening fetal circulation It recommends that methyldopa, hydralazine, labetalol, and long-acting nifedipine (only after 20 weeks of gestation) should be used as the first-choice antihypertensive oral drugs. PIH is a major cause of maternal, fetal and newborn morbidity and mortality
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