Abstract

Hypertensive disorders of pregnancy (HDP), encompassing gestational hypertension, pre-eclampsia, eclampsia, and 
chronic hypertension complicating pregnancy, remain a major contributor to maternal and perinatal morbidity and 
mortality in Nigeria. Despite established clinical guidelines, effective control of HDP is hindered by multifactorial 
challenges, including low antenatal care (ANC) coverage and delayed presentation, inadequate facility readiness, 
inconsistent guideline adherence, limited availability and affordability of essential medications, and sociocultural 
practices such as reliance on traditional remedies. Patient-level factors, including low health literacy and poor 
adherence to treatment, further exacerbate adverse outcomes. This review synthesizes recent literature on the 
prevalence, barriers, and health system gaps affecting HDP management in Nigeria and highlights pragmatic 
interventions with potential to improve outcomes. Evidence suggests that a coordinated approach integrating early 
ANC access, facility readiness packages, reliable supply chains, community education, and robust monitoring 
systems can enhance maternal and neonatal health. Policymakers and healthcare providers must implement context
specific strategies to reduce maternal and perinatal mortality associated with HDP.