Author(s): Buga GA, Lumu SB
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Abstract BACKGROUND: Hypertensive disorders are a major cause of maternal and perinatal morbidity and mortality worldwide. The incidence and complications at Umtata General Hospital have not yet been documented, but clinical experience shows that hypertension is a common and serious problem. OBJECTIVE: To determine the incidence, clinical features, complications, and perinatal outcome in patients with hypertensive disorders of pregnancy. DESIGN: A cross-sectional analytical study. SETTING: Umtata General Hospital (UGH), a referral and tertiary institution. SUBJECTS: All patients with hypertension who delivered at Umtata General Hospital from January 1993 to December 1994. MAIN OUTCOME MEASURES: The incidence, presentation, maternal complications, and perinatal outcome. RESULTS: Of the 16,376 deliveries at UGH during this period, 760 (4.6\%) were complicated by hypertension. The median age of the hypertensive women was 25 years. Teenagers comprised 27.3\% of the cases and primigravidae accounted for 42.9\% of all the cases. Proteinuric hypertension was present in 66\% of the hypertensive women at admission and in 53.8\% at delivery. Eclampsia occurred in 15\% of the hypertensives, and the incidence of eclampsia in the general obstetric population at UGH was high at 7 per 1000 deliveries. Other maternal complications of hypertension included, pulmonary oedema (3.9\%), abruptio placentae (1.7\%), HELLP syndrome (1.2\%), maternal death (1.0\%), acute renal failure (0.9\%), coma with cerebral pathology (0.5\%), and DIC (0.5\%). Hypertension accounted for 33\% of all maternal deaths during this period, and almost all were eclamptic. The perinatal complications which occurred included preterm delivery (34\%), low birthweight (19.9\%), IUFD (11.2\%), IUGR (6.6\%), and neonatal deaths (3.8\%). In general, eclamptic patients had significantly more maternal and foetal complications than non-eclamptic hypertensive women. CONCLUSION: Hypertensive disorders of pregnancy are a major cause of maternal and perinatal morbidity and mortality at UGH, as in other parts of South Africa. Only quality obstetric care can reduce the adverse effects of hypertension.
This article was published in East Afr Med J
and referenced in Journal of Hypertension: Open Access