Journal of Gynecology and Obstetrics

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High Blood Pressure in the Birth Room: Epidemiology and Outcome of Pregnancies at the General Hospital of Loandjili (Pointe-Noire, Congo)

Received: Apr. 10, 2020    Accepted: Apr. 27, 2020    Published: May 12, 2020
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Abstract

Objective: According to the World Health Organization, blood pressure disorders of pregnancy constitute a real public health problem of worldwide scope. It is an important factor of gravity, provider of a high maternal and perinatal morbidity and mortality in our maternities. The aim of this work is to study the epidemiological profile of pregnant women with hypertension and the outcome of their pregnancy. Methods: Descriptive cross-sectional study, carried out from January 1 to December 31, 2019, in the birthing block of the Obstetrics Gynecology service of the Loandjili General Hospital in Pointe-Noire, having included exhaustively and consecutively, all of them having given birth high blood pressure from a theoretical or ultrasound term of at least 22 weeks of amenorrhea or a birth weight of at least 500 g according to the WHO. New-borns of hypertensive mothers were also considered. The variables studied were socio-demographic, reproductive, linked to monitoring of pregnancy, clinical, relating to childbirth and maternal and perinatal prognosis. Results: Eighty and fourteen hypertensive pregnancies were recorded among 1677 admitted to the birthing room, a frequency of 5.6%. They were of a median age of 33, predominantly employed (60%), multigest (69%) and multiparous (44%). They were the most referred (66%) and admitted for high blood pressure or its complications in more than three quarters of cases (78%). Delivery was premature in more than half of the cases (54%), either spontaneously or induced. In this context, caesarean section was the preferred delivery route (77% of cases), performed urgently (94.4%) for severe maternal morbidity. Indications for emergency caesarean section were dominated by severe preeclampsia (67%), retroplacental hematoma (14%) and eclampsia (11%). One case of maternal death has been noted. Stillbirth was noted in 5% of cases (n=5). Neonatal morbidity was represented by poor adaptation to ectopic life (n=24 or 27%), hypotrophy (n=3 or 14%), prematurity (n=19 or 20%), neonatal resuscitation (n=24 or 27%) and the transfer to neonatology (n=45 or 48%). Conclusion: The association of high blood pressure and pregnancy remains frequent in our maternities. Given its high morbidity and mortality, it poses a real challenge for the obstetrician as to the outcome of pregnancies. The obstetrical prognosis and the improvement of the maternal and new-born prognosis go through the promotion of quality prenatal contacts and prevention.

DOI 10.11648/j.jgo.20200803.13
Published in Journal of Gynecology and Obstetrics ( Volume 8, Issue 3, May 2020 )
Page(s) 62-66
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

High Blood Pressure, Pregnancy, Epidemiology, Prognosis, Pointe-Noire, Congo

References
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[2] Mounier-Vehier C, Amar J, Boivin JM and al. Hypertension and Pregnancy: Expert Consensus Statement from the French Society of Hypertension, an Affiliate of the French Society of Cardiology. Fundam Clin Pharmacol. 2017; 31 (1): 83-103. doi: 10.1111/fcp.12254.
[3] Feihl F, Waeber B, Pradervand P-A, Vial Y. Hypertension et Grossesse. Rev Med Suisse 2009; 5: 1758 – 62.
[4] Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet 2010; 376: 631–44. (Level III)
[5] Touré I. A., Brah F., Prual A. Hypertension Artérielle et Grossesse au Niger: Etude cas /témoins à propos de 70 cas. Med Afr Noire 1997; 44 (4): 205-8.
[6] Itoua C, Ngounda Monianga AS, Ellenga Mbolla BF et al. Hypertension Artérielle et Grossesse: Epidémiologie et Pronostic Materno-fœtal au Centre Hospitalier Universitaire de Brazzaville (Congo). Med Afr Noire 2013; 6001: 21-9.
[7] Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367: 1066–74. (Systematic Review)
[8] Keen DV, Pearse RG. Weight, length, and head circumference curves for boys and girls of between 20- and 42-weeks’ gestation. Arch Dis Child 1988; 63: 1170-2.
[9] Mamelle N, Munoz F, Grandjean H pour le groupe de travail AUDIPOG. Croissance fœtale à parti de l’étude AUDIPOG. I. Établissement de courbes de références. J Gynecol Obstet Biol Reprod 1996; 25: 61-70.
[10] Mboudou ET, Foumane P, Belley Priso E et al. Hypertension au cours de la Grossesse: Aspects Cliniques et Epidémiologiques à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé, Cameroun. Clin Mother Child Health 2009; 6 (2): 1087-93.
[11] Tshabu-Aguemon C, Ogoudjobi OM, Lokossou Mègnissè Sèna HS et al. Facteurs Pronostiques de la Pre-Eclampsie Sévère à la Maternité Universitaire de Porto-Novo au Benin. Journal de la Société de Biologie Clinique du Bénin, 2017; 27: 59-64.
[12] Olié V, Moutengou E, Deneux-Tharaux C, Plu-Bureau G. Désordres Hypertensifs et Risque de Maladies Cardiovasculaires pendant la Grossesse et le Post-partum. Rev Epidemiol Santé Publique 2018; 66: 16-7.
[13] Atallah A, Lecarpentier E, Goffinet F, Gaucherand P, Doret-Dion M, Tsatsaris V. Aspirin and Preeclampsia. Presse Med 2019; 48 (1): 34-45.
[14] Mabaga JM, Mubinda PK, Mavuta CZ, Mukuku O, Kakudji PL, Luboya ON. Pronostic Perinatal aux Cliniques Universitaires de Lubumbashi. Revue de l’Infirmier Congolais 2017; 1 (1): 27-34.
[15] Kyembwa M, Juakali KV, Katenga G, Manga P, Kakoma J. Risk Factors of Pre-eclampsia in Goma (Democratic Republic of the Congo). Afr J Health Issues 2018; 3: 12. doi: 10.26875/ajhi232018xii.
[16] Thiam M, Goumbala M, Gning S. B, Fall P. D, Cellier C, Perret J. L. Maternal and Fetal Prognosis of the Higher Blood Pressure Association and Pregnancy in Sub-Saharan Africa (Senegal). J Gynecol Obstet Biol Reprod 2003; 32 (1): 35-8.
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  • APA Style

    Eouani Levy Max Emery, Buambo Gauthier Régis Jostin, Mokoko Jules Cesar, Itoua Clautaire, Potokoue Mpia Sekangue Samantha Nuelly, et al. (2020). High Blood Pressure in the Birth Room: Epidemiology and Outcome of Pregnancies at the General Hospital of Loandjili (Pointe-Noire, Congo). Journal of Gynecology and Obstetrics, 8(3), 62-66. https://doi.org/10.11648/j.jgo.20200803.13

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    ACS Style

    Eouani Levy Max Emery; Buambo Gauthier Régis Jostin; Mokoko Jules Cesar; Itoua Clautaire; Potokoue Mpia Sekangue Samantha Nuelly, et al. High Blood Pressure in the Birth Room: Epidemiology and Outcome of Pregnancies at the General Hospital of Loandjili (Pointe-Noire, Congo). J. Gynecol. Obstet. 2020, 8(3), 62-66. doi: 10.11648/j.jgo.20200803.13

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    AMA Style

    Eouani Levy Max Emery, Buambo Gauthier Régis Jostin, Mokoko Jules Cesar, Itoua Clautaire, Potokoue Mpia Sekangue Samantha Nuelly, et al. High Blood Pressure in the Birth Room: Epidemiology and Outcome of Pregnancies at the General Hospital of Loandjili (Pointe-Noire, Congo). J Gynecol Obstet. 2020;8(3):62-66. doi: 10.11648/j.jgo.20200803.13

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  • @article{10.11648/j.jgo.20200803.13,
      author = {Eouani Levy Max Emery and Buambo Gauthier Régis Jostin and Mokoko Jules Cesar and Itoua Clautaire and Potokoue Mpia Sekangue Samantha Nuelly and Kombo Boukaka Davy and Iloki Léon Hervé},
      title = {High Blood Pressure in the Birth Room: Epidemiology and Outcome of Pregnancies at the General Hospital of Loandjili (Pointe-Noire, Congo)},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {8},
      number = {3},
      pages = {62-66},
      doi = {10.11648/j.jgo.20200803.13},
      url = {https://doi.org/10.11648/j.jgo.20200803.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.jgo.20200803.13},
      abstract = {Objective: According to the World Health Organization, blood pressure disorders of pregnancy constitute a real public health problem of worldwide scope. It is an important factor of gravity, provider of a high maternal and perinatal morbidity and mortality in our maternities. The aim of this work is to study the epidemiological profile of pregnant women with hypertension and the outcome of their pregnancy. Methods: Descriptive cross-sectional study, carried out from January 1 to December 31, 2019, in the birthing block of the Obstetrics Gynecology service of the Loandjili General Hospital in Pointe-Noire, having included exhaustively and consecutively, all of them having given birth high blood pressure from a theoretical or ultrasound term of at least 22 weeks of amenorrhea or a birth weight of at least 500 g according to the WHO. New-borns of hypertensive mothers were also considered. The variables studied were socio-demographic, reproductive, linked to monitoring of pregnancy, clinical, relating to childbirth and maternal and perinatal prognosis. Results: Eighty and fourteen hypertensive pregnancies were recorded among 1677 admitted to the birthing room, a frequency of 5.6%. They were of a median age of 33, predominantly employed (60%), multigest (69%) and multiparous (44%). They were the most referred (66%) and admitted for high blood pressure or its complications in more than three quarters of cases (78%). Delivery was premature in more than half of the cases (54%), either spontaneously or induced. In this context, caesarean section was the preferred delivery route (77% of cases), performed urgently (94.4%) for severe maternal morbidity. Indications for emergency caesarean section were dominated by severe preeclampsia (67%), retroplacental hematoma (14%) and eclampsia (11%). One case of maternal death has been noted. Stillbirth was noted in 5% of cases (n=5). Neonatal morbidity was represented by poor adaptation to ectopic life (n=24 or 27%), hypotrophy (n=3 or 14%), prematurity (n=19 or 20%), neonatal resuscitation (n=24 or 27%) and the transfer to neonatology (n=45 or 48%). Conclusion: The association of high blood pressure and pregnancy remains frequent in our maternities. Given its high morbidity and mortality, it poses a real challenge for the obstetrician as to the outcome of pregnancies. The obstetrical prognosis and the improvement of the maternal and new-born prognosis go through the promotion of quality prenatal contacts and prevention.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - High Blood Pressure in the Birth Room: Epidemiology and Outcome of Pregnancies at the General Hospital of Loandjili (Pointe-Noire, Congo)
    AU  - Eouani Levy Max Emery
    AU  - Buambo Gauthier Régis Jostin
    AU  - Mokoko Jules Cesar
    AU  - Itoua Clautaire
    AU  - Potokoue Mpia Sekangue Samantha Nuelly
    AU  - Kombo Boukaka Davy
    AU  - Iloki Léon Hervé
    Y1  - 2020/05/12
    PY  - 2020
    N1  - https://doi.org/10.11648/j.jgo.20200803.13
    DO  - 10.11648/j.jgo.20200803.13
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 62
    EP  - 66
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20200803.13
    AB  - Objective: According to the World Health Organization, blood pressure disorders of pregnancy constitute a real public health problem of worldwide scope. It is an important factor of gravity, provider of a high maternal and perinatal morbidity and mortality in our maternities. The aim of this work is to study the epidemiological profile of pregnant women with hypertension and the outcome of their pregnancy. Methods: Descriptive cross-sectional study, carried out from January 1 to December 31, 2019, in the birthing block of the Obstetrics Gynecology service of the Loandjili General Hospital in Pointe-Noire, having included exhaustively and consecutively, all of them having given birth high blood pressure from a theoretical or ultrasound term of at least 22 weeks of amenorrhea or a birth weight of at least 500 g according to the WHO. New-borns of hypertensive mothers were also considered. The variables studied were socio-demographic, reproductive, linked to monitoring of pregnancy, clinical, relating to childbirth and maternal and perinatal prognosis. Results: Eighty and fourteen hypertensive pregnancies were recorded among 1677 admitted to the birthing room, a frequency of 5.6%. They were of a median age of 33, predominantly employed (60%), multigest (69%) and multiparous (44%). They were the most referred (66%) and admitted for high blood pressure or its complications in more than three quarters of cases (78%). Delivery was premature in more than half of the cases (54%), either spontaneously or induced. In this context, caesarean section was the preferred delivery route (77% of cases), performed urgently (94.4%) for severe maternal morbidity. Indications for emergency caesarean section were dominated by severe preeclampsia (67%), retroplacental hematoma (14%) and eclampsia (11%). One case of maternal death has been noted. Stillbirth was noted in 5% of cases (n=5). Neonatal morbidity was represented by poor adaptation to ectopic life (n=24 or 27%), hypotrophy (n=3 or 14%), prematurity (n=19 or 20%), neonatal resuscitation (n=24 or 27%) and the transfer to neonatology (n=45 or 48%). Conclusion: The association of high blood pressure and pregnancy remains frequent in our maternities. Given its high morbidity and mortality, it poses a real challenge for the obstetrician as to the outcome of pregnancies. The obstetrical prognosis and the improvement of the maternal and new-born prognosis go through the promotion of quality prenatal contacts and prevention.
    VL  - 8
    IS  - 3
    ER  - 

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Author Information
  • Department of Obstetrics Gynecology, Loandjili General Hospital, Pointe-Noire, Congo; Department of Obstetrics Gynecology, Hospital University of Brazzaville, Brazzaville, Congo

  • Department of Obstetrics Gynecology, Hospital University of Brazzaville, Brazzaville, Congo

  • Department of Obstetrics Gynecology, Hospital University of Brazzaville, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

  • Department of Obstetrics Gynecology, Hospital University of Brazzaville, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

  • Department of Obstetrics Gynecology, Hospital University of Brazzaville, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

  • Department of Obstetrics Gynecology, Loandjili General Hospital, Pointe-Noire, Congo

  • Department of Obstetrics Gynecology, Hospital University of Brazzaville, Brazzaville, Congo; Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Congo

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