Parameters of normotensive women and women with pregnancy induced hypertension (PIH) in Lusaka

Abstract

This paper reports results of a survey of mean arterial pressures (MAP) in a population of 125 control patients and 30 cases who developed pregnancy induced hypertension. The investigation was carried out to see if MAP would be a useful addition to methods used to screen for PIH. More of the cases had elevated MAP than did the controls, suggesting that use of this easily obtainable information may be helpful in identifying patients at risk for pregnancy--induced hypertension. Addition baseline information on the 155 patients and their pregnancy outcome is also presented.

PIP: 35 cases of pregnancy-induced-hypertension (PIH) and 125 controls taken on nonconsecutive days from 792 deliveries during the period June-August 1988 at the University Teaching Hospital, Lusaka, Zambia, were analyzed for mean arterial pressure (MAP), and contributing factors. Data were taken from delivery logs and patients' antenatal cards. The cases were women diagnosed with PIH or a history of seizures. Controls were the 5 preceding deliveries with adequate data. Results for MAP were presented as a matrix showing good outcome controls, poor outcome controls, and cases, by MAP at antenatal visits 1-4, with numbers of women in groupings by MAP ranges. There were more high MAP values for cases than for controls. Over 25% of both groups were women aged 17-19. 64.7% of cases were primigravida, compared to 43% of controls. Data on weight gain were not consistently available, but a higher proportion of cases gained 20 pounds than controls. Most women gained 0 or 1-10 pounds. 44% of cases and 41% of controls had hemoglobin 10 mg/dl. There were 4 positive VDRLs among 34 women tested. 4% of the control infants were stillborn; 7% died in hospital. Among the cases there were 1 fetal death, 2 stillborns, 4 hospital deaths, 20% pregnancy loss overall. Apgar scores were lower among cases, with 25% 4-6, compared to 3.3% of controls. These results did not indicate that MAP would be useful in comparison with blood pressure and other risk factors in monitoring pregnant women for PIH.