The pattern and obstetric outcome of hypertensive disorders of pregnancy in Nnewi, Nigeria.

BACKGROUND: Hypertension is a common medical complication of pregnancy. It is one of the leading causes of maternal and fetal mortality and morbidity worldwide. Early detection, close surveillance and timely delivery are necessary to reduce complications associated with the condition.

OBJECTIVES: To determine the pattern, risk factors, maternal and fetal outcomes in women with hypertensive disorders of pregnancy.

METHODOLOGY: This was a descriptive retrospective study of the pattern and obstetrics outcome of hypertensive disorders in Nnewi. The Obstetric variables from 148 women with hypertensive disorders of pregnancy at the Nnamdi Azikiwe University Teaching Hospital Nnewi, from the 1st January 2004 to 31st December 2008 were analyzed. Stastical analysis was done using Epi Info version 3.3.2. The level of statistical significance was set at P < 0.05.

RESULTS: of the 4021 deliveries in the hospital during the period under review, 148 (3.7%) were managed for hypertensive disorders of pregnancy. Only 138 folders were used for analysis. The mean age of the women was 31.3 +/- 5.7 years. Majority of the women were unbooked (57.2%). Pre-eclampsia was the commonest type of hypertensive disorder of pregnancy (46.4%) with the majority presenting with severe disease. The level of proteinuria was significant in 74.6% of cases of preeclampsia. The mean gestational age at delivery was 35.3 +/- 1.5 weeks. The mean birth weight was 1.6 +/- 0.3 kg. Twenty-four intra uterine deaths were recorded giving a stillbirth rate of 17.4%. The perinatal mortality rate was 20.9%. Diagnosis was made in the ante-partum period in 92.0% of the cases while 55.2% of the women delivered through Caesarean section. Eight maternal deaths were recorded, giving a case fatality rate of 5.8%.

CONCLUSION: Hypertensive disorders of pregnancy are associated with high maternal and fetal morbidity and mortality in Nnewi, Nigeria. Antenatal care will help in early diagnosis and timely intervention of the cases. There is need for strengthening of communication and referral systems in the healthcare.