TITLE:
Postpartum Hypertension in a Tertiary Care Hospital: Clinical Presentation, Management, and Short-Term Maternal Outcomes in Bangladesh
AUTHORS:
Abu Naser Md. Faiaz, Md. Sirajul Islam, Richmond Ronald Gomes, Fatema Akter Joly, Afifa Islam, Emtiazur Rahman
KEYWORDS:
Postpartum Hypertension, Preeclampsia, Eclampsia, High-Dependency Unit, Antihypertensive Therapy, Maternal Outcomes, Bangladesh
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.8,
August
12,
2026
ABSTRACT: Background: Postpartum hypertension is a leading contributor to maternal morbidity and mortality globally, especially in low- and middle-income countries. Severe postpartum hypertension often requires patients to be admitted to intensive care units (ICU) or high-dependency units (HDU) for close monitoring and management. However, data on clinical profile, management pattern, and short-term outcome of postpartum hypertension are still scarce in Bangladesh. Objective: To describe the presentation, management, and short-term maternal outcomes of women admitted to ICU/HDU with postpartum hypertension and to identify factors associated with blood pressure control. Methods: This prospective observational study was conducted at Ad-Din Women’s Medical College Hospital, Dhaka, Bangladesh. Fifty postpartum women with hypertension admitted consecutively to the ICU/HDU were enrolled. Demographic, obstetric, clinical, laboratory, treatment-related, and outcome data were collected using a structured data collection form. The primary outcome was blood pressure control within 24 hours of treatment initiation. Data were analyzed using descriptive statistics, Chi-square or Fisher’s exact test, and exploratory binary logistic regression. Results: The mean age was 27.04 years ± 6.07 years, and most women were multiparous (60.0%), delivered by caesarean section (94.0%), and admitted on postpartum day 2 (92.0%). Preeclampsia accounted for 88.0% of cases and eclampsia for 12.0%. Severe hypertension was present in 58.0% of patients. Overall, 72.0% achieved blood pressure control within 24 hours. Baseline systolic blood pressure was the only independent predictor of 24-hour BP control (AOR = 0.95, 95% CI: 0.91 - 0.99; p = 0.018). Most patients improved and were discharged (96.0%), with no maternal deaths. Conclusions: Postpartum hypertension necessitating ICU/HDU hospitalisation was mostly linked to preeclampsia and early postpartum onset. Short-term maternal outcomes were favourable, with clinical improvement in the majority of patients and no maternal deaths, following prompt protocol-based antihypertensive therapy; the observational design, however, does not allow these outcomes to be causally attributed to any specific treatment. Timely identification, immediate antihypertensive medication, and vigilant monitoring may enhance maternal outcomes and mitigate hypertension complications.