Placenta Previa and Pre-Eclampsia: Analyses of 1645 Cases at Medani Maternity Hospital, Sudan

Abstract

A retrospective case-control study was conducted to investigate the risk factors for pre-eclampsia – including the protective effect of placenta previa – at Medani Maternity Hospital, Sudan. Medical files of the patients during the period 2003–2010 were reviewed for age, parity, education level, prenatal care, placenta previa, and hemoglobin level. Women with pre-eclampsia were the cases, and women with normal pregnancy were the controls. There were 54,339 singleton deliveries and 1765 women with pre-eclampsia in the hospital, giving the incidence of pre-eclampsia of 3.2%. The risk factors for pre-eclampsia were; women with age >35 years (OR = 1.4, 95% CI: 1.1–1.8), primiparity (OR = 3.3, 95% CI: 2.7–4.0), para >5 (OR = 3.1, 95% CI: 2.4–4.0), and anemia (OR = 3.3, 95% CI: 2.8–3.9). The risk of pre-eclampsia was inversely increased with education level and prenatal care attendance. The prevalence of placenta previa was 0 (0%) and 55 (3.3%), P < 0.001 in pre-eclamptic and control women, respectively. Placenta previa was a significant protective factor of pre-eclampsia (OR = 0.3, 95% CI: 0.1–0.7). Although, the socio-demographic risk factors for pre-eclampsia observed among women at Medani hospital were similar to those found in other settings; placenta previa was associated with decreased incidence of pre-eclampsia.

Prospective cohort study of persistent hypertension following pre-eclampsia at Medani Hospital, Sudan

“…Pre‐eclampsia/eclampsia is the leading cause of obstetric complications and maternal mortality in Sudan [9–11]. Consequently, the aim of the present study was to evaluate the incidence of, and predictors for, persistent hypertension in patients with pre‐eclampsia [12–14].…”

Serum Calcium, Magnesium, Zinc and Copper Levels in Sudanese Women with Preeclampsia

“…Preeclampsia is a common medical disorder affecting about 2–7% of pregnant women worldwide [1, 2] and can lead to unfavorable pregnancy outcomes such as increased maternal as well as perinatal morbidity and morbidity [3]. The etiology of preeclampsia remains ambiguous, albeit, reports that implicated placental defects and oxidative stress early during pregnancy in affected pregnancies [4, 5].…”

“…calcium and zinc supplement [18]. In Sudan, preeclampsia/eclampsia is a major cause of maternal and perinatal morbidity and mortality [1, 19, 20]. We have previously shown that preeclampsia is associated with oxidative stress [21].…”

Hypertension and haemodynamics in pregnant women – is a unified theory for pre‐eclampsia possible?

“…It is also more common in nulliparous women, who have not had a previous pregnancy to enable adaptive uterine musculature and vascular responses to occur. It is less common in some groups where high levels of calcium intake is common [12], and in smokers [13] (who also are known to have smaller babies [13]), and there is evidence to suggest that the disease is also less common in women with placenta praevia where there is increased vascularity to the uterus and placenta [14].…”