Peculiarity of hypertension and pregnancy about 544 cases

Abstract

Hypertension and pregnancy is a clinical diagnosis defined by the new onset of hypertension (systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg. The objective of this work is to specify the epidemiological, clinical, para-clinical, therapeutic and prognostic. A total of 5946 deliveries collected at the gyneco-obstetric. All pregnant women were included in this study with the diagnosis of hypertension. This is a retrospective study of 544 cases of hypertension and pregnancy collected at the Lalla Meryem maternity hospital Ibn Rochd hospital in Casablanca for a period of 2 years. The incidence is 9.2%. The average age of onset was 30 years with an age range of 15 to 45 years. The primiparous were the most exposed 261 cases (48%). Three hundred and ten cases (57%) have an unsupported pregnancy. Two hundred and ninety cases (53.3%) had a systolic blood pressure greater than or equal to 160 mm Hg, and 160 cases (29.4%) had a diastolic blood pressure ≥ 110 mm Hg. The most used medical conduct was the combination of rest and antihypertensives. Obstetrical behavior was marked by the frequency of vaginal deliveries (63.4%). Maternal complications represent (14.7%) dominated by retro-placental hematoma (5.1%) and eclampsia (3.7%). Perinatal mortality represents 57 cases (9.9%). The factors of bad fœto-maternal prognosis are for the fetus: the low gestational age, the low parity, the non monitoring of the pregnancy, the massive proteinuria and the hyperuricemia. For the mother, young maternal age, primiparity, non-pregnancy monitoring, diastolic blood pressure ≥ 110 mm Hg, systolic blood pressure ≥ 160 mm Hg, and massive proteinuria. This study concludes that high blood pressure and pregnancy is a major cause of maternal mortality and morbidity. These complications can be reduced by a better physiopathological understanding and a better knowledge of fetal and maternal prognostic factors.