Maternal, perinatal outcome and associated factors of hypertensive disorders of pregnancy in jimma university medical center, south west Ethiopia

Abstract

Background – Hypertensive disorders of pregnancy (HDP) is one of the most common obstetric complications that occurs during pregnancy. It occurs generally in about 5 – 10 % of pregnancy and it accounts for 10 – 15 % of maternal death worldwide. Maternal complications from HDP particularly from preeclampsia and eclampsia includes abruptio placenta, pulmonary edema, ARF, aspiration pneumonia, PPH and maternal death. It also accounts for perinatal mortality particularly from prematurity and associated complications. Objective-The main objective of this study was to assess maternal and perinatal outcome of hypertensive disorders of pregnancy and associated factors at JUMC. Method – Hospital based cross sectional study was conducted among mothers admitted to JUMC, from January 1/2019 to June 30/ 2019. The consecutive sampling technique was used to select study participants. Data were collected using a structured questionnaire from both interview of respondents and the respondents‟ records. Multiple logistic regressions was used to identify independent predictors that showed significant association with dependent variables. Finally statistically significant association was declared at p value < 0.05. Result: From 1980 total admission to labor ward and maternity ward, 202(10.2%) mothers were diagnosed with HDP. Preeclampsia with severity feature was the most common presentation 121 (60 %) followed by eclampsia 23(10.4%). About one third (32 %) of the mother developed at least one maternal complication. HELLP syndrome was the most common complications (38.5) followed by aspiration pneumonia (20 %) and maternal death (2.4%). There was statistically significant association between place of residency being rural area, having eclampsia and unfavorable maternal outcome. Fifty (23.13 %) of the fetuses developed unfavorable perinatal outcome with at least one complication. There were 29 (14.4 %) still birth and 12 (5.5 %) ENND. Gestational age at delivery of 28 – 33 weeks, having eclampsia, and antepartum onset of HDP of the mother had statistically significant association with unfavorable perinatal outcome. Conclusion and recommendation: The presence of preeclampsia with severity features and eclampsia has been associated with poor maternal and perinatal outcomes which were manifested by increased maternal ICU admissions, maternal death, preterm delivery rate still birth and ENND. JUMC should give due emphasis for early recognition and management of mothers with HDP.