High blood pressure and pregnancy. Epidemiological, diagnostic, therapeutic and prognostic aspects at the regional hospital center of thies /senegal. About 851 cases

Abstract

Introduction: High blood pressure (hypertension) associated with pregnancy represents a public health problem responsible for significant maternal and neonatal mortality and morbidity in the world and in sub-Saharan Africa in particular. The objectives of this work were to describe the epidemiological, diagnostic, therapeutic and prognostic aspects of all cases of hypertension associated with pregnancy received in our structure. Methodology: This was a prospective, descriptive and analytical study of all the patients received for hypertension and pregnancy at the Maternity Department of the Regional Hospital of Thies during the period from June 20, 2015 to June 20, 2017. We studied the diagnostic, epidemiological, therapeutic and prognostic aspects. The data were entered and analyzed by the EPI NFO software version 6.04dfr. To study the influence of certain prognostic factors, we used the comparison of proportions and the Chi-square test with a significance level of 0.05. Results: We recorded 851 cases of hypertension and pregnancy out of 15,744 pregnant women, for a frequency of 5.40%. The epidemiological profile found was that of a young woman aged 20-24 (26.3%), married (91.2%), housewife (69.3%) from the commune of Thies (60.5%), primiparous (56.4%), carrier of a single pregnancy (91.5%), followed in a health post (99.1%) and evacuated in 75.9% of cases. The main signs were: headache (96.7%), edematous syndrome (85%), dipstick proteinuria ≥ ++ (89.8%), hyperuricemia> 60 mg / l (62.5 %) Therapeutically, calcium channel blockers were the main antihypertensive agents used (91.8%). Magnesium sulfate was administered to almost all patients (95.1%). 
We had a maternal lethality of 3.05% and a perinatal mortality of 14.33 deaths per 1000 births.

Conclusion: Hypertensive pathology during pregnancy is an important cause of maternal and neonatal morbidity and mortality  in our context.