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

Objective: To describe the incidence and obstetric and perinatal outcomes in primigravid Black South Africans with hypertensive disorders of pregnancy (HDP). Method: All primigravidae who booked for antenatal care were followed up until hospital discharge. Relevant clinical and demographic data were collected in structured data forms. Results: 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. Conclusion: 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.