Pre-eclampsia — high blood pressure after 20 weeks of pregnancy, with or without proteinuria — affects 5–8% of Nigerian pregnancies. It is the leading direct cause of maternal mortality in Nigeria alongside obstetric haemorrhage. The characteristic symptoms (headache, visual disturbance, upper abdominal pain, excessive swelling) are often dismissed or attributed to normal pregnancy discomfort — a fatal mistake.
Pre-eclampsia cannot be cured — only delivery resolves it. Management depends on severity and gestational age: blood pressure control with labetalol or nifedipine, magnesium sulphate for seizure prophylaxis in severe cases, and timely delivery planning. At Mascot Healthcare, blood pressure is measured at every antenatal visit and urine is tested for protein — the two essential pre-eclampsia screening tools.
Iron deficiency anaemia complicates approximately 30% of Lagos pregnancies. Causes: increased iron demand of pregnancy, pre-existing iron deficiency from heavy periods or poor diet, and malaria-related haemolysis. Consequences: maternal fatigue (severe), increased infection risk, increased risk of preterm labour and low birth weight, and increased risk of postpartum haemorrhage severity.
Prevention and treatment: iron and folic acid supplementation from the first antenatal visit, malaria intermittent preventive therapy (IPTp-SP at each antenatal visit after the first trimester), and haemoglobin monitoring at booking and 28 weeks.
Gestational diabetes affects 10–14% of Nigerian pregnancies — and most are undiagnosed because fasting blood glucose testing at 26–28 weeks is not performed at many antenatal facilities. Consequences: macrosomia (large baby) causing obstructed labour and birth injury, neonatal hypoglycaemia, and markedly increased lifetime risk of type 2 diabetes for both mother and child.
Malaria causes placental malaria — parasites sequester in the placenta causing maternal anaemia, restricted fetal growth, low birth weight, and preterm delivery — even in the absence of fever. IPTp-SP (sulfadoxine-pyrimethamine at each antenatal visit) prevents placental malaria and is recommended for all pregnant women in Lagos regardless of malaria symptoms.
About the author: Dr. Chioma Ezenwachi is women's health physician, mascot healthcare at Mascot Healthcare, Akoka, Lagos. This article is reviewed annually and updated to reflect current guidelines and data.
Pregnancy monitoring including blood pressure, anaemia, and gestational diabetes screening. By appointment, Akoka.