Postpartum trend in blood pressure and renal function in women with severe preeclampsia and eclampsia: A prospective cohort-study at Mulago hospital, Kampala, Uganda

Abstract

2Background 3 Preeclampsia/Eclampsia is a multisystem disorder of pregnancy with kidney involvement. Our 4 objective was to assess the postpartum trend in blood pressure, renal function and proteinuria 5 and, to investigate their predictors in Ugandan women with severe preeclampsia and eclampsia. 6 Methods 7This was a prospective cohort study that involved 97 women with severe preeclampsia and 8 Eclampsia, conducted at Mulago National referral hospital from August 2017 to April 2018. The 9 clinical and laboratory variables were collected from the women on day1, 7, 21 and day 42 after 10 delivery. Kaplan-Meier Survival analysis, Cox-proportional Regression and Log-Rank tests were 11 used to compare the baseline and the follow-up variables with changes in blood pressure, renal 12 function and urine protein.13 Results. 14 Most women (93.8%) recovered from hypertension within 6 weeks of childbirth with the mean 15 time to resolution of 2.49 weeks (95% CI: 2.13-2.82). About 81% of the women recovered their 16 renal function and the mean time to recovery was 24.54 days (95% CI: 20.14-28.95). Proteinuria 17 resolved in approximately 84% of the women and the mean time resolution of urine protein of 18 32.85 days (95% CI: 30.31-35.39). Having multiple pregnancy versus a singleton pregnancy was 19 associated with persistence of hypertension six weeks after child birth (P-value = 0.013).42 Keys words 43 Preeclampsia, Hypertension, Proteinuria, Renal dysfunction, Resolution, Postpartum. 44 4 46 130 glomerular filtration rate using current serum creatinine, patient race, gender and age of the 131 participant (17). The MDRD calculator was used for determining and classifying the estimated 132 glomerular filtration https://patient.info/doctor/estimated-glomerular-filtration-rate-gfr-calculator 133 Outcomes 134The primary outcome was time to resolution of the blood pressure. Secondary outcomes were 135 time to recovery of renal function and disappearance of proteinuria. The blood pressure was 136 considered normal when it was less than 140/90 mmHg without any antihypertensive 137 medications for at least one week. 138Serum creatinine level and estimated glomerular filtration were measured at every visit and were 139 considered normal when the estimated glomerular filtration was ≥ 90 mL/min/1.73 m 2

Prevalence of persistent hypertension following pregnancy complicated by hypertensive disorders in low- and middle-income countries: a systematic review

“…The reasons for excluding studies were not being able to retrieve report (n = 1) (23), while the rest did not report pHTN as the primary outcome (n = 20) (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43), wrong design (n = 2) (44,45), oral presentation (n = 1) (46), or wrong exposure (n = 1) (47). After retrieval and full-text review, 22 published reports (Supplementary Table S1) were selected for this systematic review (14)(15)(16)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65).…”