Maternal and fetal prognosis of hypertension and pregnancy in Africa (Senegal)
Thiam, M.; Goumbala, M.; Gning, S.B.; Fall, P.-D.; Cellier, C.; Perret, J.-L.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction 32(1): 35-38
2003
ISSN/ISBN: 0368-2315 PMID: 12592180 Document Number: 561975
The aims of this study were to record the different types of hypertension associated with pregnancy and to assess the incidence of hypertension and its gravity in Senegal. Over a two-year period, a cohort of pregnant women with hypertension according to the American working group classification of hypertension and pregnancy, was studied. A group of 47 non hypertensive women were matched for age and parity. Modalities of delivery were studied: maternal death, type of delivery, birth weight. Among 2,400 deliveries, hypertension was observed in 94 women wih, mean age 33 years. The incidence of hypertension was 3.9% and the incidence of preeclampsia was 2.5%. The different types of hypertension were: Type I: 44 (47%), Type II: 16 (17%), Type III: 18 (19%), Type IV: 16 (17%). Echocardiography showed 30 cases of left ventricle hypertrophy with 3 cases of systolic dysfunction. Thirty-five patients had undergone a caesarean. Forty-seven infants had a birth weight below 2,000 g. Maternal mortality was 12.7%, fetal and neonatal mortality was 50%. There was a 21-fold higher chance of caesarean section in hypertensive women (p<4 x 10-4). Neonatal mortality was 36 times higher (p (4 x 10-6) than in the control group with a birth weight lower birth weight 975 g (p<10-6). Women suffering from toxemia gave birth to children having a lower birth weight (-543 g) (p<5.10-3), but, there was no significant difference concerning caesarean (p<7*10-1) maternal, fetal and neonatal mortality (p<9. 10-1) compared with other sub-groups. In developing countries, hypertension in pregnant women is a severe condition responsible for disease and handicaps which could be avoidable at little cost through a better policy of detection and good quality multidisciplinary management.