The average age of the 146 patients was 27.06 ± 6.26 years, ranging from 17 to 43 years. The average number of pregnancies was 2.5 ± 1.6, ranging from 1 to 7 pregnancies. The average parity was 2.3 ± 1.4, ranging from 0 to 6. Married women accounted for 83.6% of our sample. Patients with no schooling accounted for 24.0% of the sample. Patients who were housewives accounted for 47.3% of the sample. Table 1 provides details on the socio-demographic characteristics of the patients.

The mean gestational age of the patients was 33.8 ± 4.2 weeks of gestation (WG), with extreme values of 20 and 42 WG. Notably, 51% of patients had a gestational age greater than 37 WG.

Figure 1 illustrates the distribution of patients according to gestational age.

Among the 146 patients, 19.8% had eclampsia as a complication. Table 2 shows the frequency of different maternal complications at admission.

Of the 146 patients, uterine evacuation was performed by cesarean section in 71.9% of cases and by vaginal delivery in 28.1% of cases.

As for the outcome of the pregnancy, a live birth was observed in 84.9% of cases. Table 3 illustrates the distribution of patients according to pregnancy outcome.

We also observed 4 cases (2.7% of patients) of death, all related to eclampsia. One maternal death occurred on day 2, two maternal deaths on day 4, and one maternal death on day 5.

On the 7th day, 45th day, and 3 months after the delivery, the percentage of patients with a diastolic blood pressure greater than 90 mmHg was 58.5%, 35.9%, and 7.0% respectively. In addition to diastolic trends, the proportion with systolic blood pressure ≥ 140 mmHg decreased across follow-up and persisted in 7.8% at 3 months postpartum. Figure 2 shows the changes in clinical signs after delivery.

The percentage of patients with proteinuria greater than 0.15 g/24 hours was 96.7% on the day of delivery, falling to 43.7%; 22.6% and 2.9% respectively on the 7th day, 45th day and 3 months after delivery ( Figure 3 ). The percentage of patients with thrombocytopenia and those with elevated blood levels of liver enzymes gradually decreased ( Figure 4 ).

The variability in the criteria used to define and diagnose preeclampsia may affect the comparison of our results with those of other studies. We used the new definition of preeclampsia adopted by FIGO, whereas most published studies used the old WHO definition, which included proteinuria as a mandatory criterion. In addition, we did not follow up with patients beyond 3 months after the end of pregnancy to obtain data on long-term outcomes. Blood pressure was measured each time in the hospital and may have been skewed by the white coat effect.

In our study, we observed a mortality rate of 2.7% after delivery, a figure that exceeds the threshold tolerated by the World Health Organization (WHO), which recommends that hospitals organize their services in such a way as to limit the mortality rate from obstetric complications to less than 1% [10] [11] . A study conducted in Ghana also reported a 2.7% mortality rate from preeclampsia during pregnancy and postpartum [12] . These results raise concerns about the quality of obstetric care and the management of complications. Several factors may contribute to this high mortality rate, including delays in the management of complications and insufficient resources within health facilities. It is therefore important to mobilize resources to ensure continuous care, which will enable health facilities to align their performance with WHO guidelines for improving maternal outcomes.

In our study, the average gestational age of patients was 33.8 ± 4.2 weeks of amenorrhea (WA), ranging from 20 to 42 WA. Notably, 51% of patients had a gestational age greater than 37 weeks, which suggests predominantly late-onset disease in this cohort. In addition, we observed that 6% of patients had a gestational age below the viability threshold of 28 GA accepted in the Burkinabe context. By way of comparison, a study conducted in China in 2021 found 17.98% of preeclampsia cases before 28 weeks of gestation [13] . This figure is significantly higher than ours, but hospitals are undoubtedly relatively better equipped to manage these cases of very early preeclampsia.

We observed a gradual regression of the clinical signs of preeclampsia after the end of pregnancy. However, it is important to note that three months after the end of pregnancy, high diastolic blood pressure persisted in 7% of patients and high systolic blood pressure in 7.8% of them. These results suggest that continuous monitoring is necessary, even after delivery, to ensure proper recovery and detect any hypertensive complications. In a study conducted by Berks et al. [14] in Netherlands, based on a sample of 205 preeclamptic patients followed for two years, it was observed that three months after delivery, 39% of women still had hypertension, a percentage that decreased to 18% after two years. These results corroborate our observations, highlighting that the resolution of postpartum hypertension can be slow and that factors such as systolic and diastolic blood pressure at the time of delivery influence this process. In fact, for every 10 mmHg increase in maximum systolic blood pressure, the resolution time increased by 60%, while for maximum diastolic pressure, this increase was 40% [14] . This underscores the importance of optimal management of hypertension during pregnancy.

In addition, a study [15] showed that the use of ambulatory blood pressure monitoring (ABPM) revealed that half of patients who had suffered from preeclampsia had persistent hypertension between the sixth and twelfth months after delivery. This finding highlights the importance of prolonged monitoring for this population, preferably by a cardiologist. In fact, a number of women also suffered from white coat hypertension, while others had masked hypertension.

In addition, authors [16] [17] examined the neurological consequences in patients who had experienced eclampsia, following a group of women over a period of several years after childbirth. They observed that a significant proportion of them had persistent neurological disorders, including headaches, mood disorders, and various other neurological problems. These data highlight the long-term impact of eclampsia on patients’ quality of life, emphasizing the importance of a multidisciplinary approach and appropriate neurological follow-up.

Finally, it is essential to reduce blood pressure gradually in order to avoid significant maternal hypotension, which could compromise the prognosis and aggravate neurological symptoms [18] [19] . In short, continuous vigilance and appropriate follow-up strategies are necessary to properly manage the blood pressure of women who have suffered from preeclampsia.

Anemia was completely corrected three months after the end of pregnancy in all patients. However, persistently high creatinine levels were noted in 2.9% of patients. Twenty-four-hour proteinuria greater than 0.15 g per liter, although gradually decreasing, remained abnormal in 3.5% of patients at three months. It should also be noted that platelet counts and liver enzymes normalized in all patients at the end of this period.

These results are consistent with a study conducted in Côte d’Ivoire [20] , which reported a significant improvement in anemia and normalization of liver tests in the months following delivery. However, this study also observed that some patients continued to have abnormal urinary parameters, including persistent levels of proteinuria, highlighting the importance of prolonged monitoring. This finding reinforces the idea that while the majority of patients experience resolution of these complications, a subgroup may require prolonged attention and multidisciplinary, in-depth follow-up.