Maternal and Perinatal Complications of Severe Preeclampsia in Three Referral Hospitals in Yaound&amp;#233;, Cameroon

Jean Dupont Kemfang Ngowa,Anny Ngassam,Sebastien Mba,Joel Fokom Domgue,Jean Alima,Jean Baptiste Bogne,Jean Marie Kasia

doi:10.4236/ojog.2015.512101

Abstract

Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptive cross sectional study from the 1st of June 2012 to the 31th of June 2014, among pregnant women with severe preeclampsia followed up in three tertiary level hospitals in Yaoundé, Cameroon: the Yaoundé General Hospital, the Yaoundé Central Hospital, and the Yaoundé University Hospital. Statistical analysis was performed using EPI 3.5.5. Data were described as means ± standard deviation, percentages and numbers. Chi-square and Fisher exact tests were used where appropriate. Results: Of the 2500 deliveries registered during the study period, 111 cases (8.49%) were managed as severe preeclampsia. Four patients refused to participate and were excluded from the study. Most of these patients were non workers (58.0%), pauciparous (61.7%) and young (median age of 27.47 years ± 6.46). Eclampsia (12.14%), abruptio placentae (11.21%) and hypertensive retinopathy (7.47%) were the most frequent maternal complications. Two cases (1.86%) of maternal deaths occurred in patients who had eclampsia. Prematurity (48.6%), intra uterine fetal death (13.1%) and oligoamnios (11.2%) were the most frequent fetal complications. All four neonatal deaths occurred in women in whom the diagnosis of severe preeclampsia was done between 28 and 33 weeks of gestation. Conclusion: Pregnancies complicated by severe preeclampsia had significantly high maternal and perinatal morbidity and mortality in Cameroon. The complications of severe preeclampsia can be prevented by more widespread use of antenatal care, education of primary medical care personnel, prompt diagnosis of high-risk patients and timely referral to tertiary medical centers.

Highlights

Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality and lead to about 10% - 15% of maternal deaths worldwide especially in developing countries [1]
About 30% of HDP are associated with chronic hypertension while 70% of cases occur in pregnant women without a history of hypertension [3]
2500 deliveries occurred in the selected hospitals and 111 (4.44%) were complicated by severe preeclampsia

Summary

Introduction

Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality and lead to about 10% - 15% of maternal deaths worldwide especially in developing countries [1]. Severe forms of HDP include preeclampsia and eclampsia, which are the leading causes of maternal death in many parts of the world [2]. About 30% of HDP are associated with chronic hypertension while 70% of cases occur in pregnant women without a history of hypertension [3]. Preeclampsia is a multisystem disorder of unknown etiology, unique to pregnancy [4]-[6]. While preeclampsia complicates 6% - 10% of all pregnancies in the United States, the incidence is believed to be even higher in underdeveloped countries [7]. In Cameroon, preeclampsia occurs in 4.9% to 7.7% of pregnancies [8]

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Results

Discussion

Conclusion