Your browser doesn't support javascript.
loading
Risks of adverse perinatal and maternal outcomes among women with hypertensive disorders of pregnancy in southwestern Uganda.
Lugobe, Henry Mark; Muhindo, Rose; Kayondo, Musa; Wilkinson, Ian; Agaba, David Collins; McEniery, Carmel; Okello, Samson; Wylie, Blair J; Boatin, Adeline A.
Afiliação
  • Lugobe HM; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.
  • Muhindo R; Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
  • Kayondo M; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.
  • Wilkinson I; University of Cambridge, Cambridge, United Kingdom.
  • Agaba DC; Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.
  • McEniery C; University of Cambridge, Cambridge, United Kingdom.
  • Okello S; Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
  • Wylie BJ; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America.
  • Boatin AA; Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
PLoS One ; 15(10): e0241207, 2020.
Article em En | MEDLINE | ID: mdl-33112915
ABSTRACT

INTRODUCTION:

Hypertensive disorders of pregnancy (HDP) are a leading cause of global perinatal (fetal and neonatal) and maternal morbidity and mortality. We sought to describe HDP and determine the magnitude and risk factors for adverse perinatal and maternal outcomes among women with HDP in southwestern Uganda.

METHODS:

We prospectively enrolled pregnant women admitted for delivery and diagnosed with HDP at a tertiary referral hospital in southwestern Uganda from January 2019 to November 2019, excluding women with pre-existing hypertension. The participants were observed and adverse perinatal and maternal outcomes were documented. We used multivariable logistic regression models to determine independent risk factors associated with adverse perinatal and maternal outcomes.

RESULTS:

A total of 103 pregnant women with a new-onset HDP were enrolled. Almost all women, 93.2% (n = 96) had either pre-eclampsia with severe features or eclampsia. The majority, 58% (n = 60) of the participants had an adverse perinatal outcome (36.9% admitted to the neonatal intensive care unit (ICU), 20.3% stillbirths, and 1.1% neonatal deaths). Fewer participants, 19.4% (n = 20) had an adverse maternal outcome HELLP syndrome (7.8%), ICU admission (3%), and postpartum hemorrhage (3%). In adjusted analyses, gestational age of < 34 weeks at delivery and birth weight <2.5kg were independent risk factors for adverse perinatal outcomes while referral from another health facility and eclampsia were independent risk factors for adverse maternal outcomes.

CONCLUSION:

Among women with HDP at our institution, majority had preeclampsia with severe symptoms or eclampsia and an unacceptably high rate of adverse perinatal and maternal outcomes; over a fifth of the mothers experiencing stillbirth. This calls for improved antenatal surveillance of women with HDP and in particular improved neonatal and maternal critical care expertise at delivering facilities. Earlier detection and referral, as well as improvement in initial management at lower level health units and on arrival at the referral site is imperative.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pré-Eclâmpsia / Mortalidade Materna / Hipertensão Induzida pela Gravidez / Eclampsia / Natimorto / Morte Perinatal Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Uganda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pré-Eclâmpsia / Mortalidade Materna / Hipertensão Induzida pela Gravidez / Eclampsia / Natimorto / Morte Perinatal Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Newborn / Pregnancy País/Região como assunto: Africa Idioma: En Revista: PLoS One Assunto da revista: CIENCIA / MEDICINA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Uganda