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Relationship of reported clinical features of pre-eclampsia and postpartum haemorrhage to demographic and other variables.

BACKGROUND
Maternal death and disability remain significant problems in developing countries and are predominantly caused by preeclampsia and postpartum haemorrhage. The diagnostic criteria for preeclampsia and postpartum haemorrhage require medical technologies not readily available in underdeveloped areas.


OBJECTIVE
To determine the correlates of pre-eclampsia and postpartum haemorrhage using symptoms in a rural setting.


METHODS
This was a cross-sectional study in which 577 women from the Kwahu South District of the Eastern Region of Ghana completed questionnaires that sought for signs and symptoms of pre-eclampsia and postpartum haemorrhage in their current or prior pregnancies. The study was conducted over a period of two months, symptoms of pre-eclampsia assessed included headache, visual disturbance, urination, breathing, leg swelling and seizures. For postpartum haemorrhage, the following features were assessed: placenta delivery, length of labour, difficult delivery of placenta, lacerations associated with delivery, size of newborn, headache, visual disturbance and amount of vaginal bleeding.


RESULTS
There was a significant association between education and the number of signs and symptoms of preeclampsia, (Χ² =9.059, =0.018; OR no education vs >7 years=6.8). Mothers with no education were about seven times more likely to have all six signs and symptoms of preeclampsia than those with seven or more years of education. There was no significant association between education and postpartum haemorrhage, (Χ² = 1.835, = 0.400). However, the OR of 1.59, indicated an inverse association between the two variables.


CONCLUSION
The high number of symptoms associated with preeclampsia among women with no formal education strongly supports the need for educational outreach and basic prenatal care in rural Ghana.