Étude du profil biochimique de l'hypertension artérielle préexistante au cours de la grossesse chez des femmes de la région de Mostaganem

Abstract

Hypertension during pregnancy is the single most important marker of maternal and fetal morbidity and mortality worldwide. It is defined by a blood‐pressure measurement exceeding 140/90 mm Hg. Two main forms are distinguished: chronic hypertension, which predates pregnancy, and gestational hypertension, which develops during pregnancy. Both forms carry similar risks: for the mother, progression to pre-eclampsia and its complications; for the fetus, intrauterine growth restriction, fetal distress, and even intrauterine demise. This study aimed to analyze changes in biochemical parameters in hypertensive pregnant women, comparing three distinct forms: pre-eclampsia, gestational hypertension, and chronic hypertension. Conducted over five weeks at the Lalla Kheira Maternity Hospital in Mostaganem, Algeria, it included 40 pregnant women—11 normotensive controls and 29 women with hypertension. The mean age of all participants was 33.02 ± 4.79 years (range: 21–43 years). A hypertension‐related questionnaire was administered to determine the main characteristics of the study population. Biochemical profiling comprised measurements of blood glucose, urea, creatinine, transaminases (AST and ALT), prothrombin time, activated partial thromboplastin time, and 24-hour proteinuria. Our results show that 65 % of hypertensive pregnancies occurred in women aged 31–40 years, with a high prevalence of obesity (55 %) and a family history of hypertension (38 %). Cesarean delivery predominated (72 %), while 79 % of patients were multiparous and 90 % were multigravida. Additionally, 40 % had gestational diabetes and 24 % met criteria for pre-eclampsia (proteinuria > 300 mg/24 h). Biochemical abnormalities in hypertensive pregnant women included hyperglycemia in those with chronic and gestational hypertension, hypercreatininemia in chronic hypertensives, and a significant increase in plasma urea and creatinine (p<0.01) in pre-eclamptic women. The latter group also exhibited elevated hepatic enzymes (AST and ALT) (p<0.05) and prolonged activated partial thromboplastin time (p<0.01). In conclusion, our work confirms a clear association between hypertensive disorders of pregnancy and disturbances in biochemical parameters.