Hypertensive Disorders of Pregnancy: : Prevalence, Maternal Complications and Perinatal Outcomes at Lilongwe Central Hospital, Malawi

Abstract

Objectives of the study were to determine the prevalence, maternal complications and perinatal outcomes of pregnancy in patients with Hypertensive Disorders of Pregnancy (HDP).

Materials and Methods: A retrospective study was done by reviewing patients’ journals at Lilongwe Central Hospital (LCH) Maternity wing from January 2003 to June 2003. Those with HDP were then selected for the study.

Results: From a total of 5248 deliveries during the period of study, 70 HDP cases were identified. Only 36 (51%) booked for antenatal care. The overall prevalence was 13 per 1000 deliveries. The mean age of the cases was 23.9 years. Among the cases 47 (67.1%) were younger women of the age group 16-25 years. Thirty-five (50%) of the 70 cases were primigravidae and 65 (93%) were married women. Of the five single mothers, eclampsia affected 4 while 45 married women were preeclamptic. There were similarities in the distribution of pre-eclampsia and eclampsia amongst the residential areas with higher number of urban cases compared to rural cases. There were 8 cases who had pregnancy induced hypertension (PIH) in their previous pregnancies. Maternal complications included 17 cases of severe preeclampsia, 24 cases of eclampsia, 3 cases of disseminated intravascular coagulation (DIC), 3 cases of acute renal failure (ARF), 1 case of pulmonary oedema, and 1 case of maternal death. Perinatal outcomes included 34 preterm deliveries, 27 low birth weight babies, 7 stillbirths and 1 neonatal death. Conclusion: The prevalence rate of HDP is lower than those of South Africa and Zimbabwe. This finding may be attributed to underutilization of maternity services (55% deliver in hospitals in Malawi). Primigravidae were the most affected group in this study (50%) of all the cases, a finding that is similar to findings of various studies.