CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Pregnancy is a physiological occurrence for a lot of women. Occasionally pregnancy won’t go smoothly as a result of different reasons or risk factors. Mothers ought to take care of their health, especially, during pregnancy to keep on with healthy pregnancy. Due to physiological changes, there are numerous health challenges women go through during pregnancy. Hypertension in pregnancy is one of the chief problems and the cause of maternal and fetus mortality. 1 Hypertension in pregnancy is clinically explained as new onset of hypertension (HTN), that is, systolic blood pressure (BP) ≥140 mm Hg and/or diastolic BP ≥90 mm Hg or an absolute rise of BP of at least 140/90 mm Hg, if the previous BP is not known or a rise in systolic pressure of at least 30 mm Hg or a rise in diastolic pressure of at least 15 mm Hg over the previously known BP, at ≥20 weeks of gestation in the absence of proteinuria.2 The occurence of Hypertension in pregnancy ranks from 5 to 15% in the different zones of the country.3 Globally 10% of all pregnancies are complicated by Hypertension in pregnancy. The main risk factors of Hypertension in pregnancy are family history, placental abnormalities, obesity (body mass index >30), previous history of HTN, hormonal imbalance, maternal age, prim gravida, and preexisting vascular disease.6 To diagnose Hypertension in pregnancy, particularly when the pregnant woman is seen for the first time after 20 weeks of gestation, or when there is no history of Blood pressure measurement before 20 weeks of pregnancy, is challenging. Nonetheless, the basis that facilitate the diagnosis of Hypertension in pregnancy and its distinction from other hypertensive disorders of pregnancy include elevated BP, which was formerly normal, non-existence of protein in the urine, and non-existence of manifestation of preeclampsia– eclampsia. Additionally, in the differential diagnosis, spot urine polymerase chain reaction; full blood count; urea, creatinine, electrolytes; ultrasound assessment of fetal growth and amniotic fluid volume; and umbilical artery Doppler assessment are generally included in the battery of test that needs to be done.7 The major difficulties of Hypertension in pregnancy are preeclampsia, eclampsia, antepartum hemorrhage, postpartum hemorrhage, and fetal death or maternal death. Thus, the study was conducted to examine the prevalence and outcome of hypertension in pregnancy A case study of UUTH Uyo
1.2 Problems of the study
Hypertensive disorders of pregnancy are one of the major causes of birthing parent mortality globally, and are linked with high rate of cesarean delivery, placental abruption, disseminated intravascular coagulation, stroke, pulmonary edema, and renal failure. 1, 2, 4, 5 These disorders so far has appeared to increase the risk of intrauterine growth restriction, premature birth, and intrauterine fetal demise. 2, 6, 7 These disadvantageous neonatal results can have both short-term sequelae, such as respiratory distress syndrome and necrotizing enterocolitis, and long-term sequelae, together with a high risk of developing type 2 diabetes mellitus and hypertension as adults. 6, 8 While chronic hypertension, explained as increased blood pressure diagnosed preceding to pregnancy or at less than 20 weeks gestation, is less common than the hypertensive disorders of pregnancy, it likewise increases the risk of these unfavourable birthing parent and neonatal outcomes. Roughly 1 in every 6 Nigerian women reside in non-metropolitan areas. 9 Compared with those living in metropolitan areas, non-metropolitan residents have a higher frequency of many risk factors for hypertension in pregnancy including elevated body mass index, diabetes mellitus, chronic hypertension, tobacco use, poverty, and lower education level. 9-13 Actually, persons living in non-metropolitan areas have the highest rates of preeclampsia, but the widespread of pre-eclampsia in metropolitan areas has been growing at a faster rate over the years. Strikingly, non-metropolitan areas have a scarcity of obstetrical services, with over half of all non-metropolitan counties lacking an obstetric unit, and obstetrical units continue to close in disproportionate numbers in non-metropolitan areas. 11, 14-16 Since any form of hypertension in pregnancy mostly needs management by an obstetrician gynecologist, persons living in non-metropolitan areas may be at increased risk for adverse outcomes compared to those living in metropolitan areas, though little published data exists. The study will therefore examine the prevalence and outcome of hypertension in pregnancy A case study of UUTH Uyo.
1.3 Objectives of the study
This study was conducted to estimate the prevalence and outcomes of hypertension pregnancy and its risk factors among pregnant women. Following objectives include;
1. To examine the arrangement of hypertensive disorders in pregnancy among pregnant women in UUTH Uyo.
2. To ascertain the risk factors for hypertensive disorders in pregnancy among pregnant women in UUTH Uyo.
3. To evaluate the outcomes of hypertensive disorders in pregnancy among mothers and pregnant women in UUTH Uyo.
4. To analyse the barriers for early detection and management of hypertensive disorders of pregnancy UUTH Uyo.
1.4 Research questions
1. What are the arrangements of hypertensive disorders in pregnancy among pregnant women in UUTH Uyo?
2. What are the risk factors for hypertensive disorders in pregnancy among pregnant women in UUTH Uyo?
3. What is the outcome of hypertensive disorders in pregnancy among mothers and pregnant women in UUTH Uyo?
4. What are the barriers for early detection and management of hypertensive disorders of pregnancy UUTH Uyo?
1.5 Significance of the study
The study, Prevalence and outcome of hypertension in pregnancy A case study of UUTH Uyo, will communicate to policy makers to develop proper screening and treatment instructions, design avoidance and manage procedures for hypertensive disorders of pregnancy. Into the bargain, it will be vital to boost the standard of services that is given for women with hypertensive anarchy in health facilities. More so, it will be a good source of knowledge for clinicians and assist them in identifying and keeping eye on women with hypertensive disorders of pregnancy and eventually boost standard of care. By the same token, it may direct them in providing health education on the area which can subscribe for better birth alertness and ready for any women complication. In addition, it will aid as a base path resource to conduct more studies in this area.
1.6 Scope of the study
The study will focus on prevalence and outcome of hypertension in pregnancy A case study of UUTH Uyo.
