Obstetric outcome of pregnancies complicated by hypertensive disorders of pregnancy

Abstract

Background: Hypertensive disorders of pregnancy are of significant public health concern due to associated maternal and perinatal morbidity and mortality. Objective: To determine the trend and obstetric outcome of pregnancies complicated by hypertensive disorders in a tertiary hospital in South-East Nigeria. Materials and Methods: Patients managed for hypertensive disorders from January 1, 2012, to December 31, 2017 were recruited for the study. Case files of patients were retrieved, and information on sociodemographic variables, risk factors, and fetomaternal outcome were extracted using a pro forma. Data analysis was done using International Business Machine-Statistical Package for the Social Sciences Version 20 (IBM-SPSS Version 20, New York, USA ). Ethical clearance was obtained from the ethics and research committee of the institution. Results: During the study period, there were a total of 14,181 deliveries, of which 785 women were managed for hypertensive disorders of pregnancy, thus giving a prevalence of 5.5%. Preeclampsia accounted for 62% (487) while chronic hypertension was 4.3% (34). There was a rising trend from 2012 with a peak in 2017. About 60% (181) of the patients were not booked for antenatal care. The predominant risk factors were advanced maternal age 14.2% (43) and previous history of hypertensive disorder 13.6% (41). Almost half of the patients had caesarean section (46.4%, 140). Preterm births were recorded in 56.6% (171) of the patients. Maternal and perinatal deaths were recorded in 0.7% (2) and 16.2% (941) of the patients, respectively. Conclusion: This study showed that hypertensive disorders of pregnancy remain a significant cause of adverse maternal and perinatal outcomes in pregnancy. Adequate antenatal coverage, early diagnosis, and improved emergency obstetric care services are needed to reverse the trend.