title: LINKING UNINTENDED PREGNANCY TO THE BURDEN OF PRE-ECLAMPSIA IN A TERTIARY HOSPITAL IN GHANA.
abstract: BACKGROUND
  Although pre-eclampsia remains a major public health challenge associated with significant adverse maternal outcomes especially in low-income countries, there are no well-defined screening and preventive measures. However, primary prevention of unintended pregnancy represents a viable and reliable measure for reducing the high maternal morbidity and mortality attributable to pre-eclampsia.
  
  
  OBJECTIVE
  To determine and relate the proportion of unintended pregnancies among pre-eclamptic women to the burden of pre-eclampsia in Korle-Bu Teaching Hospital (KBTH), Accra, Ghana.
  
  
  METHODS
  A cross-sectional study involving pregnant women with pre-eclampsia conducted at the KBTH, Accra, Ghana. Structured questionnaire was employed to obtain the required data regarding pregnancy intendedness and the use of modern contraception. Data on maternal mortality were also collected to determine maternal deaths related to pre-eclampsia. The data obtained were analyzed using SPSS version 18.
  
  
  RESULTS
  There were 269 women with hypertensive disorders in pregnancy with 177 (65.8%) having pre-eclampsia out of which 100 met the inclusion criteria and 86 gave informed consent. Most, 71(82.6%), were married and 69 (80.2%) had had at least Junior High School education with a mean age of 29.34±1.08 years. The prevalence of unintended pregnancy among the women with pre-eclampsia was 32.6% as 28 patients were affected with 12 (13.9%) women on modern contraception prior to the index pregnancy. However, 83 (96.5%) had adequate knowledge on modern contraception and 58 (67.4%) reported of a previous history of induced abortion. As many as 16 (57.1%) women of those whose pregnancies were unintended were not using any form of contraception. During the study period, 36 maternal deaths occurred and 14 (38.9%) were due to pre-eclampsia.
  
  
  CONCLUSIONS
  Unintended pregnancy constitutes a significant proportion of the burden of pre-eclampsia in the Ghanaian population resulting in high maternal morbidity and mortality. Increasing contraceptive usage in general represents a viable and effective primary preventive measure in reducing maternal mortality attributable to pre-eclampsia.
authors.affiliation: Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana.
authors.forename: K
authors.initials: K
authors.lastname: Adu-Bonsaffoh
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
authors.forename: J D
authors.initials: JD
authors.lastname: Seffah
keywords: Contraception; Ghana; Maternal mortality; Pre-eclampsia; Unintended pregnancy