Pregnancy outcome in primigravidae with late onset hypertensive disease

Background: The perinatal mortality associated with pre-eclampsia is extrem ely high and it is mainly associated with early onset disease in multiparou s women. Hypertension without proteinuria in late pregnancy may not he asso ciated with high perinatal mortality rates. Objectives To establish the perinatal outcome in primigravidae women with h ypertension occurring in late pregnancy, that is, at thirty fourth week or later. Design: Prospective case-control study, Setting: Labour ward of King Edward VIII Hospital, Durban, South Africa, Patients: Three hundred and twenty two primigravidae consisting of 161 hype rtensives and 161 controls. Main outcome measures: Maternal and foetal morbidity and mortality. Results: The hypertensive group was divided into those with proteinuria (gr oup a) and without proteinuria (group b), The mean birthweight of babies bo rn to proteinuric hypertensives was significantly lower than that of hypert ensives without proteinuria and the normotensive group (2.4 kg (a) versus 2 .8 kg (b) versus 3.02 kg (c) respectively a versus b, p = 0.0001; a versus c, p = 0.001; b versus c, p = 0.009). There were nine perinatal deaths and all occurred in the proteinuric hypertension group. Conclusions Primigravidae with late onset proteinuric hypertension had smal ler babies and higher perinatal mortality than their aproteinuric hypertens ive and normotensive controls.