High Blood Pressure in the Birth Room: Epidemiology and Outcome of Pregnancies at the General Hospital of Loandjili (Pointe-Noire, Congo)

Abstract

Objective: According to the World Health Organization, blood pressure disorders of pregnancy constitute a real public health problem of worldwide scope. It is an important factor of gravity, provider of a high maternal and perinatal morbidity and mortality in our maternities. The aim of this work is to study the epidemiological profile of pregnant women with hypertension and the outcome of their pregnancy. Methods: Descriptive cross-sectional study, carried out from January 1 to December 31, 2019, in the birthing block of the Obstetrics Gynecology service of the Loandjili General Hospital in Pointe-Noire, having included exhaustively and consecutively, all of them having given birth high blood pressure from a theoretical or ultrasound term of at least 22 weeks of amenorrhea or a birth weight of at least 500 g according to the WHO. New-borns of hypertensive mothers were also considered. The variables studied were socio-demographic, reproductive, linked to monitoring of pregnancy, clinical, relating to childbirth and maternal and perinatal prognosis. Results: Eighty and fourteen hypertensive pregnancies were recorded among 1677 admitted to the birthing room, a frequency of 5.6%. They were of a median age of 33, predominantly employed (60%), multigest (69%) and multiparous (44%). They were the most referred (66%) and admitted for high blood pressure or its complications in more than three quarters of cases (78%). Delivery was premature in more than half of the cases (54%), either spontaneously or induced. In this context, caesarean section was the preferred delivery route (77% of cases), performed urgently (94.4%) for severe maternal morbidity. Indications for emergency caesarean section were dominated by severe preeclampsia (67%), retroplacental hematoma (14%) and eclampsia (11%). One case of maternal death has been noted. Stillbirth was noted in 5% of cases (n=5). Neonatal morbidity was represented by poor adaptation to ectopic life (n=24 or 27%), hypotrophy (n=3 or 14%), prematurity (n=19 or 20%), neonatal resuscitation (n=24 or 27%) and the transfer to neonatology (n=45 or 48%). Conclusion: The association of high blood pressure and pregnancy remains frequent in our maternities. Given its high morbidity and mortality, it poses a real challenge for the obstetrician as to the outcome of pregnancies. The obstetrical prognosis and the improvement of the maternal and new-born prognosis go through the promotion of quality prenatal contacts and prevention.