Hypertensive Disorders of Pregnancy: Epidemiology, Clinical and Management in Kisangani

Abstract

Background: Hypertensive disorders of pregnancy (HDP) are a major cause of maternal and perinatal morbidity and mortality in low-resource settings. Aims: This study aimed to describe the epidemiology, clinical characteristics, and management of HDP in Kisangani, Democratic Republic of Congo. The objective was to improve the management of pregnant women with hypertensive disorders in Kisangani to reduce maternal and neonatal morbidity and mortality. Methods: We conducted a retrospective descriptive study in four health facilities in Kisangani from January 1 to December 31, 2023. Among 1,768 pregnant women admitted during the study period, 97 cases of HDP were identified (prevalence: 5.5%; 95% CI: 4.5–6.7). HDP was defined according to standard criteria: systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg after 20 weeks of gestation, with or without proteinuria ≥3 g/24 h (preeclampsia). Data were analyzed using R software. Results: The mean age was 25.1 ± 3.47 years (range: 16–41), while 59.8% (58/97; 95% CI: 49.6–69.3) were aged ≤19 years. Most women were primiparous (52.6%; 51/97; 95% CI: 42.2–62.8), and 60.8% initiated antenatal care at ≥20 weeks of gestation. HDP was diagnosed in the third trimester in 91.8% of cases. The most common forms were gestational hypertension (47.4%; 46/97; 95% CI: 37.3–57.7), preeclampsia (32.0%), and eclampsia (20.6%). Alpha-methyldopa was the most frequently used treatment (45.4%). Vaginal delivery occurred in 74.2% of cases. Neonatal mortality was 5.2%, and 7.2% of newborns had low birth weight. Conclusion: In Kisangani, HDP are relatively frequent and predominantly affect young, primiparous women, often diagnosed late, highlighting the need to strengthen early antenatal care and timely management to improve maternal and neonatal outcomes.