Introduction: Severe preeclampsia continues to be a major problem worldwide with approximated prevalence ranging from 2%-8%. Despite the good outcome of a well-managed preeclampsia, 10% to 15% them end up dying due to preeclampsia-related complications (1). Severe preeclampsia is a multisystem disorder that presents clinically with hypertension and proteinuria. This is due to problems in the liver, kidneys, brain, lungs and the clotting system (2). It is estimated that 50,000 women die yearly in developing countries from preeclampsia. The incidence of severe preeclampsia ranges between 0.6 to 1.2% in developed countries. Severe preeclampsia occurring below the 34 weeks of gestation complicate 0.3% of pregnancies and those pregnancies are associated with higher rates of maternal and perinatal mortality and morbidities worldwide (3.4). At antenatal ward of Bugando Medical Centre (BMC) admissions due to severe preeclampsia ranged between 16.5% and 22% in last two years (5). Among these, about 1% of them died of complications. Overall, six percent of all maternal deaths are attributed to severe preeclampsia. Although proteinuria is one of the defining factor for preeclampsia, the absence of detectable protein in urine does not necessarily exclude the diagnosis of preeclampsia: but its presence indicates the disease is severe to the extent of damaging the kidneys and other vital organs (6-8).

Maternal complications of severe preeclampsia include elampsia, eclamptic stroke, abruption platenta, pulmonary edema renal failure, coagulopathy, HELLP syndrome and retinopathies. Other outcomes include increased risk of caesarian section and operative vaginal deliveries, especially when it occur remote from term. Prolonged hospital stay and increase perinatal morbidity and mortality have been also associated with severe preeclampsia (9). The complications of severe preeclampsia to the baby include poor intrauterine fetal growth, low apgar score and prematurity (2, 10).

Despite the incidence of eclampsia being 1.37% as demonstrated by the study done at BMC, the prevalence of maternal and fetal outcomes of severe preeclampsia has not been documented (3) Therefore, the aim of this study was to analyze the incidence, maternal and fetal outcome of severe preeclamptic patients at both primary and tertiary hospitals.