Abstract
Introduction: Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. Methods: The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values Results: During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%; eclampsia: 3.6%; puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases; it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013); family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013); history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p Conclusion: The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.
Highlights
Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae
With regard to maternal complications after childbirth, we have: - Severe hypertension: defined within 6 weeks of delivery by systolic blood pressure (SBP) ≥ 160 mmHg and/or diastolic blood pressure (DBP) ≥ 110 mmHg on two occasions 4 hours apart and 06 weeks postpartum by an SBP ≥ 180 mmHg and/or DBP ≥ 110 mmHg [14] [15]. - Eclamptic seizure: tonic-clonic seizures occurring in the setting of pre-eclampsia followed by post-critical coma [16]
Frequency of HDP in the gynaecological-obstetric service in 2020 During our study period 298 cases of HDP were admitted to the gynaecological-obstetric service out of a total of 1904 admissions, i.e. a hospital frequency of 15.6%
Summary
Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. In Yaoundé in 2018, Amougou et al found an incidence of 2.8% of hypertension in women with a history of pre-eclampsia [6] This shows that HDP can lead to chronic hypertension exposing the patient to its multiple complications [7]. In Parakou, in 2015 at the University and departmental hospital of Borgou in the north of Benin, the frequency of hypertension in pregnancy was 6.2% including 33.9% of pre-eclampsia [9]. The frequency of severe pre-eclampsia was 4.7% in 2012 [10] and 5.6% in 2015 [11] at University and Departmental Hospital of Borgou Despite these significant figures, the outcome of women with HDP remains poorly documented in our country. Knowing that hypertension during pregnancy strongly increases the risk of developing chronic arterial hypertension, we initiate this work to evaluate the prognosis, in the postpartum period, of patients suffering from HDP in order to appreciate the extent of the phenomenon in our country and to contribute to a better prevention
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