Prevalence, associated factors, and pharmacotherapy of hypertensive disorders among parturients in Bono Region of Ghana: An analytical cross-sectional study
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Background
The burden of hypertensive disorders among parturients in remote locations of Ghana remains understudied, considering existing data. We investigated the prevalence, associated factors, and treatment guideline’s adherence for maternal hypertensive disorders among parturients in a peripheral region.
Method
In an analytical cross-sectional study, data of all parturients with hypertensive disorders were extracted from labor registers of nine public hospitals in the Bono Region of Ghana from January to December 2021. Additionally, guidelines for administering magnesium sulfate and antihypertensives to these patients were examined. Chi-square and multivariable binomial regression analyses were used to explore associations between independent and dependent variables. P ≤ 0.05 was considered statistically significant.
Results
Hypertensive pregnancies were 711 out of 16,206 deliveries, with a prevalence of 4.4%. Non-severe pre-eclampsia (30.5%) and gestational hypertension (28.0%) were the most frequent disorders. Eclampsia (6.2%) and superimposed pre-eclampsia (1.7%) were less frequent. Maternal age, 15-25 years (cOR = 2.43; 95% CI = 1.57-3.75; p < 0.001), unemployment (cOR = 2.14; 95% CI = 1.29-3.53; p = 0.001), primigravida (cOR = 2.88; 95% CI = 1.80-4.62; p < 0.001), and primiparity (cOR = 2.39; 95% CI = 1.44-3.96; p < 0.001) were significantly associated with pre- eclampsia/eclampsia. After adjustment for confounders, primiparity remained a borderline significant predictor (aOR = 1.83; 95% CI= 0.97-3.46; p = 0.05). Oral nifedipine (30mg) and intravenous hydralazine were the primary medications for pregnant hypertensives. Magnesium sulfate was universally administered by the Pritchard procedure, but product concentrations supplied by pharmacists for intramuscular application varied minimally.
Conclusion
The prevalence of hypertensive disorders among parturients was 4.4%. Young parturient age, unemployment, primigravida, and primiparity were the predictors. Magnesium sulfate protocols for managing pre-eclampsia/eclampsia cases followed a standard regimen. Standardizing the concentration of magnesium sulfate solutions for pre-eclampsia/eclampsia could optimize intramuscular dosing under the Pritchard regimen, improving treatment consistency.
