P N Ebeigbe1, M E Aziken. 1. Department of Obstetrics and Gynaecology, College of Health Sciences, Delta State University, Abraka, Nigeria. petedidi2000@yahoo.co.uk
Abstract
CONTEXT: Pregnancy - induced hypertension/eclampsia is a major cause of maternal and perinatal morbidity and mortality in Nigeria. There have been very few studies focused on early onset pregnancy induced hypertension/eclampsia in Nigerian women. OBJECTIVES: To determine the incidence, clinical features and outcome of cases of early onset pregnancy-induced hypertension /eclampsia in a Nigerian tertiary hospital, and compare maternofetal outcome in early and late onset disease. Methods : A retrospective study of all cases of early onset pregnancy induced hypertension/eclampsia seen over a five-year period in a tertiary hospital. MAIN OUTCOME MEASURES: Severity of disease, rates of induction of labour, caesarean section rate, maternal mortality, abruptio placenta, still births, severe birth asphyxia and early neonatal deaths. RESULTS: Early onset pregnancy induced hypertension/eclampsia contributed 6.3% of all cases of hypertensive disorders in pregnancy with an incidence of 1:141 deliveries. Most cases presented at between 28-32 weeks gestation (78.3%) The disease was severe at presentation or rapidly progressive in 39 cases (84.8%) leading to delivery within 72 hours of presentation. Caesarean section was the mode of delivery in 58.7% of cases. The perinatal survival rate was 34.0%. Early onset pregnancy induced hypertension was associated with significantly higher risk of presenting with eclampsia, having induction of labour and worse perinatal outcome than late onset disease. CONCLUSION: Most cases of early onset pregnancy induced hypertension in the study population presented with severe and rapidly progressive disease and were associated with significantly higher risk of obstetric intervention and worse perinatal outcome than late onset disease.
CONTEXT: Pregnancy - induced hypertension/eclampsia is a major cause of maternal and perinatal morbidity and mortality in Nigeria. There have been very few studies focused on early onset pregnancy induced hypertension/eclampsia in Nigerian women. OBJECTIVES: To determine the incidence, clinical features and outcome of cases of early onset pregnancy-induced hypertension /eclampsia in a Nigerian tertiary hospital, and compare maternofetal outcome in early and late onset disease. Methods : A retrospective study of all cases of early onset pregnancy induced hypertension/eclampsia seen over a five-year period in a tertiary hospital. MAIN OUTCOME MEASURES: Severity of disease, rates of induction of labour, caesarean section rate, maternal mortality, abruptio placenta, still births, severe birth asphyxia and early neonatal deaths. RESULTS: Early onset pregnancy induced hypertension/eclampsia contributed 6.3% of all cases of hypertensive disorders in pregnancy with an incidence of 1:141 deliveries. Most cases presented at between 28-32 weeks gestation (78.3%) The disease was severe at presentation or rapidly progressive in 39 cases (84.8%) leading to delivery within 72 hours of presentation. Caesarean section was the mode of delivery in 58.7% of cases. The perinatal survival rate was 34.0%. Early onset pregnancy induced hypertension was associated with significantly higher risk of presenting with eclampsia, having induction of labour and worse perinatal outcome than late onset disease. CONCLUSION: Most cases of early onset pregnancy induced hypertension in the study population presented with severe and rapidly progressive disease and were associated with significantly higher risk of obstetric intervention and worse perinatal outcome than late onset disease.