ABSTRACT
This study set out to determine the pattern; seasonal presentation and the challenges encountered by anesthesiologists in the care of patients with hypertension in pregnancy at caesarean section in a centre short of anaesthetic manpower without an intensive care unit. Method A retrospective assessment of anaesthetic records of patients presenting in theatre for caesarean section was done with particular reference to mode of anaesthesia; complication including fetal and maternal outcome in the immediate perioperative period from 2004 to 2008 Results Hypertensive disease in pregnancy constituted 13.1of caesarean section cases; with peaks of presentation commonly between February and June. The months of September and October also experience lower and less frequent peak incidents in tandem with periods of peak rainfalls in the Niger- Delta. This corroborates studies done in other parts of the world including northern and eastern Nigeria. The incidence in The Niger-Delta was remarkably higher than other parts of Nigeria and other rain forest zones. Of these; 50were eclamptics; 45had pre-eclamspia while other hypertensive diseases constituted the balance of 5. 60.6of these patients had General anaesthesia -relaxant technique; 18.1had intravenous ketamine (plus hypotensive adjuvant) ; 11.7spinal anaesthesia while others had epidural; combined-spinal epidural (CSE) and local infiltration with sedation. Four intraoperative maternal deaths were experienced; while fetal mortality was 8.6Conclusion : The higher incidence of pre-eclampsia/ eclampsia in the Niger-Delta compared to other parts of the rain forest and the world makes it an issue of significant public health concern in this region. Health education; accessibility to skilled health care services and ease of transportation in this region would reduce the morbidity and mortality associated with this disease
