Pregnancy-induced hypertension (PIH) is a major health concern in Nigeria, affecting 6.4 per cent of women across 54 referral-level health facilities, according to a 2024 study. The study, which involved 71,758 women, found that gestational hypertension accounted for 49.8 per cent of cases, while pre-eclampsia and eclampsia accounted for 9.5 per cent and seven per cent respectively. This condition can lead to poor pregnancy outcomes for both mothers and children if not properly managed.
Consultant Obstetrician and Gynaecologist, Lewis Aituma, says there is no single cause of PIH, but several factors can increase a woman's risk. These risk factors include previous PIH, first pregnancy, advanced maternal age, diabetes, kidney disease, a long interval between pregnancies, family history of hypertension, multiple pregnancy, and obesity. Women above 35 years, women who had never given birth, women with several previous births, and those with a previous caesarean section or miscarriage are more likely to develop hypertensive disorders of pregnancy.
Early detection and treatment of PIH are crucial to preventing serious complications. Mr Aituma advises pregnant women to have their blood pressure checked routinely and watch for rising values. Women should also report persistent headaches, blurred vision, a feeling of abnormal heartbeat, chest pain, and rapidly increasing swelling of the legs. The World Health Organisation (WHO) recommends monitoring blood pressure during pregnancy to help prevent serious complications.
If PIH is not identified and properly managed, it can progress to pre-eclampsia and cause serious complications for the mother, including eclampsia, seizures, stroke, and kidney failure. For the baby, it can increase the risk of premature birth, poor fetal growth, fetal death, and premature separation of the placenta. The Nigerian study found that 11.9 per cent of pregnancies affected by hypertensive disorders ended in stillbirth, while 3.7 per cent of women with the disorders died.
The WHO identifies preterm birth, restricted fetal growth, placental abruption, and maternal or fetal death among possible complications of severe hypertensive disorders in pregnancy. Mr Aituma says treatment depends on the severity of the condition and how far the pregnancy has progressed. For less severe forms, effort will be geared towards blood pressure control and prevention of complications until the pregnancy is delivered.
In severe cases, the priority is to control the woman's blood pressure, prevent seizures, and deliver the baby when necessary. The WHO recommends close monitoring, blood pressure treatment, and timely delivery where required, depending on the severity of the condition and gestational age. Mr Aituma advises pregnant women to maintain a healthy weight, exercise, make appropriate lifestyle changes, and attend regular antenatal appointments to reduce the risk of complications.
Overall, the prognosis is good in early diseases if women watch out for common symptoms in pregnancy and report them promptly to their Obstetrician for action. By taking proactive steps, pregnant women can reduce their risk of developing PIH and ensure a healthy pregnancy.
Key points
- Pregnancy-induced hypertension affects 6.4 per cent of women in Nigeria.
- Early detection and treatment of PIH are crucial to preventing serious complications.
- Maintaining a healthy weight and attending regular antenatal appointments can help reduce the risk of complications.
