Prevalence, placenta development and perinatal outcomes of women with hypertensive disorders of pregnancy at Komfo Anokye Teaching Hospital

Abstract

BackgroundOne of the most common medical problems associated with pregnancy is hypertension. Hypertensive disorders of pregnancy (HDP), which has been attributable to abnormal placentation may have adverse effects on both mother and foetus if left unchecked. The objective of this study was to determine the prevalence of Hypertensive Disorders of Pregnancy (HDP), the morphological variations of human placenta in HDP, and maternal and perinatal outcomes in HDP. Materials and MethodsThis was a prospective case-control study, conducted at Komfo Anokye Teaching Hospital (KATH), Ghana. The progression of pregnancy in normotensive and hypertensive pregnant women, and the eventual perinatal outcomes were closely followed. Statistical analysis was performed using IMB-SPSS version 23. Associations were considered significant at p values of [≤] 0.05. ResultsFrom a total of 214 deliveries recorded during the period of study, 84 (39.25%) were hypertensives. Forty four (52%) of the hypertensives had preeclampsia, 28 (33.3%) had gestational hypertension, 6 (7.1%) had eclampsia, 4 (4.8%) had chronic hypertension, and 2 (2.4%) had preeclampsia superimposed on chronic hypertension. The frequency of placental haematoma, placental infarction, and placental calcification in the normotensives were significantly (p=0.001) lower than that of the hypertensives. The mean placental weight (p = 0.01), placental volume (p = 0.001), placental diameter (p = 0.03), and placental thickness (p = 0.001) of the normotensives were significantly higher than those of the hypertensives. The number of normotensives in whom labour was induced, who had their babies delivered by caesarean section, and who were admitted after they had given birth were significantly (p=0.001) lower than that of hypertensives who underwent similar procedures. No stillbirths were recorded in the normotensives compared with four in the hypertensives. The number of babies delivered to the normotensives who were admitted to the NICU was significantly (p=0.001) lower than those delivered by hypertensives. ConclusionThere was a high prevalence of hypertensive disorders of pregnancy in the study site. The condition adversely affected placental development and perinatal outcomes. These adverse effects can be curtailed by embarking on a vigorous health education drive.