[Maternal and fetal prognosis of hypertension and pregnancy in Africa (Senegal)].

OBJECTIVES

The aims of this study were to record the different types of hypertension associated with pregnancy and to assess the incidence of hypertension and its gravity in Senegal.

METHODS

Over a two-year period, a cohort of pregnant women with hypertension according to the American working group classification of hypertension and pregnancy, was studied. A group of 47 non hypertensive women were matched for age and parity. Modalities of delivery were studied: maternal death, type of delivery, birth weight.

RESULTS

Among 2,400 deliveries, hypertension was observed in 94 women wih, mean age 33 years. The incidence of hypertension was 3.9% and the incidence of preeclampsia was 2.5%. The different types of hypertension were: Type I: 44 (47%), Type II: 16 (17%), Type III: 18 (19%), Type IV: 16 (17%). Echocardiography showed 30 cases of left ventricle hypertrophy with 3 cases of systolic dysfunction. Thirty-five patients had undergone a caesarean. Forty-seven infants had a birth weight below 2,000 g. Maternal mortality was 12.7%, fetal and neonatal mortality was 50%. There was a 21-fold higher chance of caesarean section in hypertensive women (p<4 x 10-4). Neonatal mortality was 36 times higher (p (4 x 10-6) than in the control group with a birth weight lower birth weight 975 g (p<10-6). Women suffering from toxemia gave birth to children having a lower birth weight (-543 g) (p<5.10-3), but, there was no significant difference concerning caesarean (p<7*10-1) maternal, fetal and neonatal mortality (p<9. 10-1) compared with other sub-groups.

CONCLUSION

In developing countries, hypertension in pregnant women is a severe condition responsible for disease and handicaps which could be avoidable at little cost through a better policy of detection and good quality multidisciplinary management.