High blood pressure; growing concern for pregnant women
Monday, January 22, 2024
A community health worker interacts with a pregnant woman with her husband at Mubuga Hospital in Karongi District on December 9, 2022. OLIVIER MUGWIZA

Seven months into her pregnancy, Vestine Nyiransabimana started feeling drowsy in the mornings and often woke up with blurry vision. Her feet would swell and she felt hot all the time.

Many a time she thought these were just common characteristics of pregnancy, considering that her first pregnancy similarly gave her a hard time. However, the more the pregnancy grew, the more these signs exhibited themselves.

"The headache became severe and I was feeling pain in my joints and below the ribs. My hands and face were also beginning to swell. When I started feeling nauseated, I decided to go and see a doctor,” she said.

At Ruhengeri Referral Hospital, Nyiransabimana was informed that she was suffering from preeclampsia, a high blood pressure or hypertensive disorder that often occurs during pregnancy.

The doctor observed elevated protein levels in her urine, indicating potential kidney damage, a condition known as proteinuria, which can result in organ damage.

"I panicked. I had no history of high blood pressure, not even in my family. Luckily, I was told it was still manageable and I immediately started medication and observing the doctor’s orders.”

Nyiransabimana was caught off-guard by the condition, which in many ways altered her way of life.

Despite a steady decline in global maternal mortality, preeclampsia or eclampsia remains the second most common cause of maternal deaths according to the World Health Organisation (WHO), with at least 10 out of 100 women who are five months pregnant and above, getting diagnosed with the condition.

The condition accounts for an estimated 343,000 annual deaths globally, most of them occurring in developing regions in Sub-Saharan Africa and Southern Asia. In Rwanda, high blood pressure is becoming more prevalent among pregnant women.

According to the Ministry of Health, in Rwanda, the leading causes of preeclampsia include preeclampsia in a previous pregnancy, being pregnant with more than one baby, chronic high blood pressure or hypertension, kidney disease and obesity, among other causes.

Stephen Rulisa, a medical doctor and professor of obstetrics and gynaecology at the School of Medicine and Pharmacy at the University of Rwanda (UR), said preeclampsia is becoming more prevalent among pregnant women today, more than ever, because of the aforementioned risk factors.

"High blood pressure during pregnancy is a serious problem indeed because as one vets high blood pressure, it reduces perfusion of placenta to the baby so this leads to under perfusion/ undernourishment of the foetus,” Rulisa explained.

As most studies indicate, one’s lifestyle or medical history can point towards the person suffering from a life-threatening condition during pregnancy.

"One of the leading causes these days is the lifestyle that has changed recently and nutrition, such as sedentary lifestyles when people don’t pay attention to physical exercise and nutrition,” he said.

"One needs to do routine check-ups, especially during pregnancy,” Rulisa said, adding that it is important for pregnant women to observe their bodies and act quickly if the need arises.

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Despite being a major cause of maternal mortality, the prevalence of preeclampsia and eclampsia is not well documented, and the associated data are scarce, especially in rural areas, but doctors say it can be prevented.

Alphonse Butoyi, a medical doctor at Croix du Sud Hospital, said blood pressure in pregnant women is becoming more prevalent and that one has to check and act when they start to experience signs.

"Most times people will experience symptoms but they don’t seek medical help. This can be fatal for both the mother and child if not well taken care of,” Butoyi noted.

Healthcare providers have urged pregnant women to monitor their blood pressure and the health of the foetus regularly, starting early on and continuing throughout pregnancy.