High Blood Pressure and Pregnancy: Epidemiological, Clinical, and Therapeutic Aspects at the University Hospital Center of Libreville from August 1, 2022 to July 31, 2023

Objective: To study the epidemiological and clinical aspects of high blood pressure and pregnancy at the University Hospital Center of Libreville from August 1, 2022 to July 31, 2023. Patients and method: This cross-sectional analytical study reviewed all complete records of women admitted to the high-risk pregnancy unit with hypertension between 1 August 2022 and 31 July 2023 at the University Hospital Center of Libreville (CHUL). Gestational hypertension was defined as new-onset blood pressure ≥ 140/90 mm Hg on two occasions at least 4 h apart after 20 weeks’ gestation without proteinuria; pre-eclampsia as hypertension plus proteinuria ≥ 300 mg/24 h or protein/creatinine ratio ≥ 0.3 or dipstick ≥ 1+ or signs of maternal organ dysfunction; chronic hypertension as hypertension predating pregnancy or diagnosed before 20 weeks’ gestation; and superimposed pre-eclampsia as chronic hypertension with new-onset proteinuria or maternal organ dysfunction. Blood pressure was measured by trained staff using an automated device, in the seated position after a 5 min rest, and two readings were averaged. Outcomes included mode of discovery, clinical form, risk factors and complications. Chi-squares tests were used to examine associations, with significance set at p Results: Hypertensive disorders of pregnancy represented 20.6% (n = 231) of parturient admitted to the high-risk maternity-unit. The average age was 29.5, (range 15 - 44). High blood pressure was more common in the 10 - 19-year age group (41.9%), followed by the 20 - 29-year group (35.4M). It was most often discovered incidentally during prenatal consultations or when a pregnancy complication occurred. Pre-eclampsia (59.7%) and gestational hypertension (37.2%) were the most represented clinical forms. Primigravidity (72.2%) and personal or family history of hypertension (15.6%) were common. Maternal complications occurred in 12% of cases, chiefly eclampsia and retroplacental hematoma. Conclusion: Hypertensive disorders of pregnancy remain frequent in Libreville and are dominated by pre-eclampsia. Strengthened antenatal screening and management are needed.