We survived high blood pressure, but our babies didn’t

Ashley Muteti (left) and Muthoni Mambo. Both ladies are survivors of pre-eclampsia, a blood pressure condition that happens during pregnancy. PHOTOS | POOL

On the eve of delivering her baby, Muthoni Mambo went to bed all cheerful. And she felt energetic too.

“I did not have blood pressure issues the entire pregnancy. My pregnancy journey was okay. I did not have complications,” says Ms Mambo.

The 37-year-old, who works as an administrator, says she had experienced an easy pregnancy and expected nothing less than to see and hold her bundle of joy at the end of the journey.

Little did she know the trauma she went through barely a year earlier was awaiting her.

“I started experiencing headaches, which I considered normal. But it escalated to a point that I have never experienced in my entire life. The pain was pulsing at the back of my head, and it was so strong, I felt like a vein could burst. Then I felt sharp pains in my upper stomach,” the emotional mother of one recalls.

At around 3am, she rushed to the hospital, accompanied by her husband.

“When my blood pressure was taken, it was at 203 [normal blood pressure level is 120/80 mmHg]. This was crazy abnormal. I was put on a drip to reduce the pain and pressure. When my baby’s heart was checked, it was too late, I had lost my second child to what the doctor said was as a result of pre-eclampsia,” says Ms Mambo.

“All the doctors said was that I was lucky to be alive with such blood pressure, and it was all God.”

Muthoni Mambo, a survivor of pre-eclampsia, a blood pressure condition that happens during pregnancy. PHOTO | POOL

In 2021, Ms Mambo lost her second pregnancy to pre-eclampsia [a serious blood pressure condition that develops during pregnancy] at just five months, after developing complications that presented with swollen legs, which she overlooked and thought was normal for an expectant woman to have swellings in the ankles, a condition called oedema.

It is no different experience with Esther Wambui, 38, who almost lost her pregnancy at seven months five years ago.

“I did not have any history of high blood pressure. All my clinic visits were okay. I just noted that my feet were swollen but I assumed it was normal for any pregnant woman. Along the journey, a friend who happens to be a nurse visited and noted that my face was swollen too. I had not even noticed,” the entrepreneur narrates.

“She acted quickly and rushed to buy some high-blood pressure tablets. When we checked my pressure, it was too high. I was rushed to the clinic where my gynaecologist issued an admission letter. The baby was removed surgically the following day weighing 1.1 kilos. She stayed in the neonatal intensive care unit (NICU) for 28 days and was discharged weighing 1.8 kilos. She will be turning five years next month,” says Ms Wambui.

Despite the advancements in maternal care and the increase in the number of well-equipped maternity hospitals, studies show hypertensive disorders in pregnancy remain a leading cause of maternal mortality. It accounts for about 20 percent of maternal deaths.

Ms Muthoni and Ms Wambui are among the thousands of women in Kenya experiencing the life-threatening condition during their pregnancy.

About 10 million pregnant women around the world develop pre-eclampsia each year. About 76,000 women die from pre-eclampsia and related hypertensive disorders, ranking it the second cause of maternal deaths worldwide, after haemorrhage.

The World Health Organisation (WHO) estimates the number of babies who die from these disorders every year at 500,000.

Dr Felix Oindi, an assistant professor and consultant obstetrician/gynaecologist at the Aga Khan University Hospital, Nairobi, says pre-eclampsia is a pregnancy disorder characterised by high blood pressure, especially after 20 weeks of pregnancy.

Though pregnant women with pre-eclampsia are usually asymptomatic and only learn of their condition through blood pressure testing at a prenatal medical visit, postpartum pre-eclampsia, he says, develops suddenly, since the symptoms are frequently overlooked.

“Its characteristic symptoms include fatigue, swelling in the face, hands or legs (though mild swelling is common in pregnancy and may be normal), nausea, shortness of breath, headaches and pain in the back or shoulders which can be difficult to distinguish from more run-of-the-mill maternal complaints,” says Dr Oindi.

“It can be dangerous to both the mother and the unborn baby. Gestational pregnancy may increase the risk of the premature birth of the baby, damage to the organs, and Cesarean delivery.”

While any pregnant woman can develop preeclampsia, certain factors increase the likelihood. For instance, women who are pregnant for the first time have a higher risk of developing preeclampsia as well as those who had preeclampsia in a previous pregnancy.

Age is also a risk factor with under 20s and over 40s being the most vulnerable.

“Those with multiple pregnancies such as twins, triplets, or more are also at a higher risk. Obese women (high body mass index of above 30) are also more likely to develop preeclampsia.

And those who have undergone assisted reproductive techniques to conceive such as in vitro fertilisation or other assisted reproductive methods also have a slightly higher risk,” he says.

Dr Oindi advises any pregnant woman with any of the signs to promptly contact her healthcare provider. “Regular prenatal check-ups and blood pressure monitoring are crucial during pregnancy to detect any potential issues early on,” he says.

After going through an ordeal barely six months of pregnancy, Ashley Muteti, who was 25 at that time was later diagnosed with high blood pressure, which later developed into pre-eclampsia.

“During my stay at the hospital, I met 10 other expectant mothers, seven of whom also had similar hypertension during pregnancy though, like me, they had no idea what the life-threatening condition was,” she says.

Ms Muteti survived her pregnancy, but her daughter, Zuri, who was born prematurely, died 49 days after birth. In her daughter’s memory, Zuri Nzilani Foundation was born, in 2019.

Ashley Muteti, the Founder of Zuri Nzilani Foundation and a pre-eclampsia survivor. PHOTO | POOL

“It is a fully registered Nairobi-based non-profit organisation, which seeks to strengthen maternal healthcare in Kenya by financially and emotionally supporting pregnant people, increasing training opportunities for healthcare professionals, and running digital education campaigns on the importance of prenatal care,” she says of the foundation that has up to 250 pre-eclampsia survivors in 42 counties.

Ms Muteti’s vision is to establish a team that focuses on maternal health in each region.

Because postpartum pre-eclampsia is less well-understood, Dr Oindi says, if someone has experienced preeclampsia in a previous pregnancy and plans to have another baby, it is essential to take certain precautions and work closely with their healthcare provider to manage potential risks.

“Once pregnant, consistent prenatal check-ups are essential to closely monitor blood pressure and other potential signs of preeclampsia to help in early detection. We also recommend the use of a low-dose aspirin regimen during their pregnancy to reduce the risk of developing pre-eclampsia.”

Untreated, postpartum pre-eclampsia can progress rapidly and can lead to life-threatening complications, even death.

“We need to be encouraging women to listen to their bodies, and to seek help right away if something doesn’t feel right,” Dr Oindi said. “I just cannot overstate that enough.”

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