- Title
- Prevalence and risk factors of imaging confirmed neurological complication amongst patients withhypertensive disorders in pregnancy admitted at Nelson Mandela Academic Hospital
- Creator
- Sabona, Ncumisa
- Subject
- Medicine
- Date Issued
- 2023-00
- Date
- 2023-00
- Type
- Masters theses
- Type
- text
- Identifier
- http://hdl.handle.net/11260/9868
- Identifier
- vital:74635
- Description
- Hypertensive disorders in pregnancy (HDP) are the world's second leading cause of maternal mortality and morbidity, with sub-Saharan Africa taking the lead. The prevalence of HDP in Africa is 10%, remarkably higher than the reported global range of 5.2-8%. This study aimed to determine the prevalence and associated risk factors of CT-confirmed neurological complications in patients managed at the labour ward at Nelson Mandela Academic Hospital (NMAH) over two years. Methodology: A retrospective cross-sectional study was conducted on obstetric patients with clinical files at NMAH from January 2018 to December 2020. We tracked and merged hospital admission data and radiological (brain CT) findings in patients managed for HDP at the labour ward at NMAH within the specified period. Descriptive analysis, bivariate and multivariate logistic regression analysis was performed to identify associated clinical risk predictors of neurological complications. Major findings: Of the 5119 patients with HDP, 153 underwent CT scans. Our study found that 78.2% of the scanned patients with HDP were between 18 and 34 years old. Patients younger than 18 years accounted for 10% of the 154 patients who underwent CT-scan. We found that 81.1% had abnormal CT-brain findings, while 18.9% were normal. The most common abnormal finding was posterior reversible encephalopathy syndrome (PRES) (25.1%), followed by cytotoxic oedema (16,5%), neurocysticercosis (15.1%), and dural sinus thrombosis (7.9%). The most common neurological findings on admission were headache (82%), low GCS (60.1%), fits (55.6%), blindness (28.8%), and focal signs (11.5%). In addition, the following risk predictors were statistically associated with PRES: post-partum onset ( aOR=6.26,95% CI 1.02-38.83, p-value0.049 ), blindness (aOR=3.19, 95% CI; 1.07-9.59, p=0.038) and fits (aOR=0.20, 95% CI: 0.64-0.63, p-value=0.006. Recommendations and clinical implications: The most common radiological finding among obstetric patients with HDP in this study is PRES. The most significant risk predictors for PRES are the post-partum onset of symptoms and blindness. As PRES is | 3 associated with significant morbidity and mortality, vigilance and aggressive management should be continued and include the post-partum period.
- Description
- Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Format
- computer
- Format
- online resource
- Format
- application/pdf
- Format
- 1 online resource (36 pages)
- Format
- Publisher
- Walter Sisulu University
- Publisher
- Faculty of Medicine and Health Sciences
- Language
- English
- Rights
- Faculty of Commerce and Administration
- Rights
- All Rights Reserved
- Rights
- Open Access
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | SOURCE1 | Sabona Ncumisa.pdf | 1 MB | Adobe Acrobat PDF | View Details Download |