Hypertensive Disorders of Pregnancy at Chu Point G
Introduction: Hypertension during pregnancy remains one of the main causes of maternal and perinatal morbidity and mortality in the world, especially in developing countries. The objective was to evaluate the clinical and paraclinical aspects of hypertensive disorders of pregnancy in the obstetrics and gynecology and cardiology departments of the Point G University Hospital.
Methodology: This was a cross-sectional descriptive study with prospective recruitment over 7 months from July 1, 2023, to January 31, 2024, including hypertensive pregnant women admitted and followed in the obstetrics and gynecology and cardiology departments during the study period.
Results: Out of 686 pregnancies, 325 had arterial hypertension, giving a hospital frequency of 47.3%. The most represented age group was that of 20 to 30 years old, accounting for 44.4% of cases. Housewives were the most represented (62.8%) and nulliparity was at 36.9%. Prenatal consultations (PC) were carried out once or twice in 48.9% of cases, and only 6.66% of these PCs were done by an obstetrician-gynecologist. A history of hypertension before pregnancy was found in 13.53%. The dominant functional signs upon admission were headaches (31.94%), convulsions (21.18%), bleeding (18.75%), and dyspnea (6.94%). There was severe hypertension in more than half (58.50%). We noted anemia, hypercreatininemia, and significant proteinuria in 30.8%, 6.46%, and 70% respectively. The ECG showed regular sinus tachycardia in 22% and left ventricular hypertrophy in 11.48%. The main hypertensive disorder was preeclampsia, accounting for 75.7% of cases, followed by added preeclampsia at 12.3%, gestational hypertension at 6.5%, and chronic hypertension at 5.5% of cases. Overall, 85% of patients experienced complications dominated by eclampsia (44.60%), retroplacental hematoma HRP (38.12%), acute renal injury (4.31%), and 0AP (3.95%). Intrauterine fetal death (IUFD), prematurity, and abortion were the main fetal complications, accounting for 61.70%, 16.59%, and 14.04% respectively.
Conclusion: hypertension associated with pregnancy remains dominated by multiple maternal- fetal complications whose management requires multidisciplinary collaboration.