PP.24.18

Abstract

Objective: The main objective was to estimate the prevalence of preeclampsia in pregnant women in Tizi-ouzou (Algeria). Secondary objectives were to estimate the frequency of preeclampsia risk factors described in the literature, and the incidence of maternal and fetal complications. Design and method: The study was prospective observational, including all women viewed for a routine pregnancy follow-up in the two maternity units of Tizi-ouzou, between January 2012 and June 2013. Were excluded chronic hypertension, hypertension diagnosed before 20 weeks’ gestation and chronic kidney diseases. Gestational hypertension was defined as systolic blood pressure (SBP) superior or equal to140 mm Hg and/or diastolic blood pressure (DBP) superior or equal to 90 mm Hg (2 measures at 48 hours interval). Preeclampsia was diagnosed as gestational hypertension associated with proteinuria >300 mg/24 h. To estimate the prevalence of preeclampsia with an accuracy of 1%, we calculated that we needed to include at least 2800 pregnant women. Results: 3225 pregnant women were included. The prevalence of preeclampsia was 7.8% (CI 95%: 6.9%-8.7%). The median SBP, DBP and gestational age at diagnosis were 145 mm Hg (IQR: 135–160), 94 mm Hg (IQR: 87–100) and 31.4 weeks, repectively. The frequency of risk factors of preeclampsia was as follows: age >40 years (27%), nulliparous (56%), obesity or BMI >35 kg/m2 at the first visit (26%), twinning (5%), previous gestational hypertension (21%), familial history of gestational hypertension (6%), diabetes (3.8%) and autoimmune disease (1.7%). Antihypertensive drugs were used in 76.6% of cases. The incidence of maternal adverse events including death, eclampsia, stroke, pulmonary edema, thrombocytopenia <50.103/mm3, alanine transaminase >70 UI/l, serum creatinine >150 μmol/l, HELLP syndrome, placental abruption and major postpartum haemorrhage was 28.7% (CI 95%: 23.1%-34.3%). The rate of fetal death, prematurity and small for gestational age infant was 6.7% (CI 95%: 3.6%-9.8%), 58.2% (CI 95%: 52.1%-64.3%) and 49.7% (CI 95%: 43.5%-55.9%), respectively. Conclusions: The prevalence of preeclampsia in Tizi-ouzou is 8%. The incidence of maternal and fetal adverse outcome remains high. The possibility of earlier diagnosis that would allow new biological tests dosing biomarkers involved in the patophysiology of preeclampsia could improve the prognosis.