Maternal deaths attributable to hypertensive disorders in a tertiary hospital in Ghana

Adu‐Bonsaffoh, Kwame; Oppong, Samuel A.; Binlinla, Godwin; Obed, Samuel A.

doi:10.1016/j.ijgo.2013.05.017

Cited by 60 publications

(72 citation statements)

References 10 publications

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“…The mean gravida was 2 ± 1.6 [1][2][3][4][5][6][7][8][9] and the mean parity was 1 ± 1.5 [8]. Six patients (4.8%) had a past history of preeclampsia and 24 patients (19 %) had chronic HPT.…”

Section: Resultsmentioning

confidence: 99%

“…Six patients (4.8%) had a past history of preeclampsia and 24 patients (19 %) had chronic HPT. The mean number of prenatal care visits was 4 ± 1 [1][2][3][4][5][6][7]. Table 2 shows the distribution of study patients according to their past medical history.…”

Section: Resultsmentioning

confidence: 99%

“…Conversely in Africa and Asia hypertensive disorders accounted for 9% of maternal deaths [22]. More recent datain SSA have demonstrated that hypertensive disorders are currently leading cause of maternal mortality [4,[23][24][25][26]. Higher mortality rates are observed with poor monitoring of the pregnancy and in Blacks (Afro-Americans) [27], probably suggesting that some independent factors could be associated with the pathology (health system and/or socio-economic level).…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension (HPT) during pregnancy is a worrying issue despite the implementation of strategies aiming to improve maternal and child health. Hypertensive disorders in pregnancy are leading cause of maternal and perinatal mortality and morbidity [3][4][5][6]. The prevalence of HPT during pregnancy ranges up to12% worldwide [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of HPT during pregnancy ranges up to12% worldwide [7][8][9][10]. In SSA data on hypertensive disorders in pregnancy are disparate, fragmentary and mainly hospital-based [4,10,11]. Due to their unpredictable nature and potential poor outcomes, patients with hypertensive disorders in pregnancy warrant cautious care with multidisciplinary team involvement to optimize both maternal and fetal outcomes [6].…”

Section: Introductionmentioning

confidence: 99%

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Hypertension in Pregnancy at the Teaching Hospital of Yalgado Ou?draogo, Burkina Faso

Georges¹

2015

J Hypertens

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hypertension in Pregnancy at the Teaching Hospital of Yalgado Ou?draogo, Burkina Faso

Georges¹

2015

J Hypertens

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A novel 12‐hour versus 24‐hour magnesium sulfate regimen in the management of eclampsia and preeclampsia in Ghana (MOPEP Study): A randomized controlled trial

Beyuo

Lawrence

Kobernik

et al. 2022

Intl J Gynecology & Obste

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Objective We compared the efficacy of a 12‐h versus 24‐h regimen of intramuscular magnesium sulfate in the management of eclampsia and preeclampsia. Methods This is an open‐labeled parallel randomized controlled trial conducted in Accra, Ghana from November 2018 to November 2020. Participants were adult pregnant women admitted to the Korle Bu Teaching Hospital (KBTH) with a diagnosis of antepartum, intrapartum, or postpartum eclampsia or preeclampsia with severe features, having received no more than a loading dose of magnesium sulfate prior to admission at KBTH. Participants in the standard 24‐h group received a loading dose of magnesium sulfate 4 g intravenous and 10 g intramuscular (5 g in each buttock) followed by six, 5 g intramuscular maintenance doses over 24 h. Participants in the 12‐h intervention group received the same loading dose followed by three, 5 g intramuscular maintenance doses over 12 h. The primary outcome was occurrence of seizure after completion of the assigned magnesium sulfate regimen. Secondary outcomes were magnesium sulfate toxicity, magnesium sulfate side effects, maternal outcomes (mode of delivery, duration of inpatient admission, duration of urethral catheterization), maternal complications (pulmonary edema, acute kidney injury, intensive care unit admission, death), and neonatal outcomes. Results Among 1176 total participants, we found no difference in occurrence of seizure after completion of the assigned regimen in the 24‐h group (n = 5, 0.9%) versus the 12‐h group (n = 2, 0.3%), P = 0.29; RR 0.40, 95% CI 0.08, 2.04), or in occurrence of seizure any time after enrollment (n = 9, 1.5% vs. n = 5, 0.9%, P = 0.28, RR 0.55, 95% CI 0.19–1.64). Participants in the 12‐h group had a shorter duration of inpatient admission (9.4 ± 8.8 vs. 7.7 ± 6.5 days, P = 0.0009) and urethral catheterization (2.1 ± 1.0 vs. 1.9 ± 1.3 days, P < 0.0001). Rates of side effects from magnesium sulfate were lower in the 12‐h group: pain at the injection site (94.8% (n = 548) vs. 91.5% (n = 540), P = 0.03), inflammation (62.2% (n = 358) vs. 40.0% (n = 237), P < 0.0001), and bleeding or bruising at the injection site (25.1% (n = 144) vs. 14.4% (n = 85), P < 0.0001). Conclusions Compared with 24 h, 12 h of intramuscular magnesium sulfate showed similar rates of seizures, with fewer side effects and shorter inpatient admission. Trial Registration Prospective registration was with Pan African Clinical Trial Registry (PACTR201811515303983): https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=4690.

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Pre‐eclampsia and heart failure: a close relationship

Orabona

Sciatti

Prefumo

et al. 2018

Ultrasound in Obstet & Gyne

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Maternal deaths attributable to hypertensive disorders in a tertiary hospital in Ghana

Abstract: Hypertensive diseases are the leading cause of maternal death at KBTH, having overtaken obstetric hemorrhage, with eclampsia, acute renal failure, intracerebral hemorrhage, and pulmonary edema representing the major immediate causes of hypertension-related maternal death.

Cited by 60 publications

References 10 publications

Hypertension in Pregnancy at the Teaching Hospital of Yalgado Ou?draogo, Burkina Faso

Hypertension in Pregnancy at the Teaching Hospital of Yalgado Ou?draogo, Burkina Faso

A novel 12‐hour versus 24‐hour magnesium sulfate regimen in the management of eclampsia and preeclampsia in Ghana (MOPEP Study): A randomized controlled trial

Pre‐eclampsia and heart failure: a close relationship

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