Superimposed preeclampsia: epidemiological, clinical, and prognostic aspects in four hospitals in the city of Douala, Cameroon

Abstract

Introduction: Superimposed preeclampsia (PE) is the occurrence of PE in a woman with chronic hypertension after 20 weeks of gestation. It is a common condition of varying severity. The aim of our study was to evaluate the epidemiological, clinical, and prognostic aspects of superimposed preeclampsia in four hospitals in the city of Douala

Materials and methods: A cross-sectional analytical study with prospective data collection was conducted among 178 patients in four hospitals in the city of Douala, Cameroon. Socio-demographic and clinical characteristics were collected. Multivariate analysis was used to identify the typical profile and complications associated with the onset of superimposed PE.

Results: Preeclampsia was the most frequently found entity in 52% of cases, followed by gestational hypertension in 26.9% (n=47) of cases, then superimposed preeclampsia with 16.0%. The mean age of the study population was 29.85 ± 6.27 years. Retroplacental hematoma was the maternal complication significantly associated with superimposed PE (OR = 4.200 [1.142; 15.441]; P = 0.031). Acute fetal asphyxia, intrauterine growth retardation, prematurity, fetal death in utero, and perinatal death were significantly associated with superimposed PE (P values: 0.000; 0.039; 0.000; 0.016; 0.005, respectively).

Conclusion: Although superimposed PE is less common, it is associated with higher maternal and fetal morbidity and mortality. We recommend close monitoring of patients with chronic hypertension in order to improve their maternal and fetal prognosis.