Hypertensive disorders in primigravid black South African women: A one-year descriptive analysis

To describe the incidence and obstetric and perinatal outcomes in primigravid Black South Africans with hypertensive disorders of pregnancy (HDP).

All primigravidae who booked for antenatal care were followed up until hospital discharge. Relevant clinical and demographic data were collected in structured data forms.

A total of 5860 primigravidae delivered during the study period. Of these, 731 had an HDP, giving an incidence of 12.5%. The diagnosis of gestational hypertension was made in 6.7% of all primigravidae but was the commonest HDP subcategory (n = 394/731; 53.9%). On the other hand, mild to moderate preeclampsia or non-severe preeclampsia, severe preeclampsia, and eclampsia occurred in 222, 84, and 31 of the 5860 primigravidae, respectively. Therefore, preeclampsia-eclampsia syndrome occurred in 337/5860 or 5.75% of the study population. Severe preeclampsia occurred in 1.43% (84/5860) of the primigravidae. The rates of caesarean deliveries in women with preeclampsia were approximately 50%. There were no perinatal deaths in the gestational hypertension group, but the overall perinatal mortality rate in all preeclamptics was 5.9%, in comparison to 2.2% in all primigravidae.

Hypertensive disorders of pregnancy developed in 12.5% (n = 731/5860) of primigravidae seen over a one-year period. Gestational hypertension comprised the commonest subcategory of the HDP and there were no perinatal deaths in this group.