Postpartum trend in blood pressure and renal function in women with severe preeclampsia and eclampsia: A prospective cohort-study at Mulago hospital, Kampala, Uganda

Abstract

AbstractBackgroundPreeclampsia/Eclampsia is a multisystem disorder of pregnancy with kidney involvement. Our objective was to assess the postpartum trend in blood pressure, renal function and proteinuria and, to investigate their predictors in Ugandan women with severe preeclampsia and eclampsia.MethodsThis was a prospective cohort study that involved 97 women with severe preeclampsia and Eclampsia, conducted at Mulago National referral hospital from August 2017 to April 2018. The clinical and laboratory variables were collected from the women on day1, 7, 21 and day 42 after delivery. Kaplan-Meier Survival analysis, Cox-proportional Regression and Log-Rank tests were used to compare the baseline and the follow-up variables with changes in blood pressure, renal function and urine protein.ResultsMost women (93.8%) recovered from hypertension within 6 weeks of childbirth with the mean time to resolution of 2.49 weeks (95% CI: 2.13-2.82). About 81% of the women recovered their renal function and the mean time to recovery was 24.54 days (95% CI: 20.14-28.95). Proteinuria resolved in approximately 84% of the women and the mean time resolution of urine protein of 32.85 days (95% CI: 30.31-35.39). Having multiple pregnancy versus a singleton pregnancy was associated with persistence of hypertension six weeks after child birth (P-value = 0.013).ConclusionIn this study, the blood pressure and renal function of most women with severe preeclampsia and eclampsia normalized within six weeks after childbirth. A special interdisciplinary follow up for patients with preeclampsia/eclampsia by an obstetrician and physician is needed in the postpartum period to reduce the maternal morbidity and mortality associated with this condition in our community.