Perinatal outcomes of hypertensive disorders in pregnancy at a tertiary hospital in Ghana

Abstract

BackgroundHypertensive disorders in pregnancy remain a major global health issue not only because of the associated high adverse maternal outcomes but there is a close accompaniment of significant perinatal morbidity and mortality especially in Sub-Saharan Africa (SSA). However, the perinatal burden of HDP in Ghana has not been explored. We conducted this study to determine the perinatal outcomes of HDP at a tertiary hospital in Ghana.MethodsA cross-sectional study conducted between January to February 2013 at Korle Bu Teaching Hospital (KBTH) in Accra, Ghana. Data collection involved baseline review of all the obstetric population who had just delivered to identify those with HDP. An informed consent was obtained after which a structured questionnaire was adminstered to the hypertensive mothers. The medical records of the mothers and their babies were also reviewed to determine the perinatal outcome indicators of relevance to the study. Data obtained were analyzed using SPSS version 20.ResultsWe included 368 women with HDP and singleton births with a mean gestational age at delivery of 37.4 ± 3.3 weeks. Adverse perinatal outcomes determined include the following: 91 (24.7%) neonates were admitted to the Neonatal Intensive Care Unit, 56 (15.2%) had neonatal respiratory distress/asphyxia with 14 (3.8%) requiring ventilatory support and 80 (21.7%) were delivered preterm. Also, stillbirth, early neonatal death, intrauterine growth restriction and low birth weight occurred in 25 (6.8%), 14 (3.8%), 23 (6.1%) and 91 (24.7%) respectively with a perinatal mortality rate of 106 per 1000 births. One and 5 minute APGAR scores <7 occurred in 125 (34.0%) and 55 (14.7%) neonates respectively. Most of the adverse perinatal outcomes were significantly more common in those with preeclampsia compared to the other hypertensive disorders.ConclusionThere is a significant burden of perinatal morbidity and mortality associated with HDP in the Ghanaian obstetric population and these adverse outcomes were more prevalent in preeclampsia compared to the other hypertensive disorders. Regular goal-oriented clinical audit into perinatal morbidity and mortality associated with HDP and an active multidisciplinary approach to the management of these disorders in the hospital might improve the clinical outcomes of women with maternal hypertension.

Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study

“…The incidence of stillbirth among women with PIH in this study was 10%. This result was more or less consistent with the study conducted in Uganda (13.1% and Ethiopia (10%) (21,24) but higher than the study conducted in Zimbabwe (5.4%), Ghana (6.8%) (20,41). This difference might be related with the difference in the access and quality of antenatal care and obstetric care service among health care institutions.…”

Effect of pregnancy induced hypertension on pregnancy outcome: a hospital based cross sectional study at a tertiary care hospital

“…8 They noted that 24.7% of the new born children were to be admitted to NICU due to complications arising out of delivery to the women with hypertensive disorders of pregnancy. 15.2% of the cases among neonates developed asphyxia.…”

Comparison of C-reactive proteins level in gestational hypertension and in normal pregnancy in 2nd and 3rd trimester and its correlation with maternal and foetal outcome

“…mean gestational age at delivery was 37.4±3.3 weeks, which is associated with adverse perinatal outcomes in subjects having Hypertensive disorders of pregnancy 19. Similarly, birth weight was lower in study group (1.97±0.38) as compared to control group (2.45±0.35) and this difference was also statistically significant (P value <0.001).…”