Pregnancy outcome in primigravidae with late onset hypertensive disease.

BACKGROUND

The perinatal mortality associated with pre-eclampsia is extremely high and it is mainly associated with early onset disease in multiparous women. Hypertension without proteinuria in late pregnancy may not be associated with high perinatal mortality rates.

OBJECTIVE

To establish the perinatal outcome in primigravidae women with hypertension occurring in late pregnancy, that is, at thirty fourth week or later.

DESIGN

Prospective case-control study.

SETTING

Labour ward of King Edward VIII Hospital, Durban, South Africa.

PATIENTS: Three hundred and twenty two primigravidae consisting of 161 hypertensives and 161 controls.

MAIN OUTCOME MEASURES: Maternal and foetal morbidity and mortality.

RESULTS

The hypertensive group was divided into those with proteinuria (group a) and without proteinuria (group b). The mean birthweight of babies born to proteinuric hypertensives was significantly lower than that of hypertensives without proteinuria and the normotensive group (2.4 kg (a) versus 2.8 kg (b) versus 3.02 kg (c) respectively--a versus b, p = 0.0001; a versus c, p = 0.001; b versus c, p = 0.009). There were nine perinatal deaths and all occurred in the proteinuric hypertension group.

CONCLUSION

Primigravidae with late onset proteinuric hypertension had smaller babies and higher perinatal mortality than their aproteinuric hypertensive and normotensive controls.