Examining Hypertension and Maternal Mortality Rates in West Africa: A Narrative Review

Maternal mortality remains disproportionately high across West Africa, reflecting a convergence of clinical risk (hypertensive disorders of pregnancy, HDP), delayed recognition of danger signs, and health-system constraints. Hypertension in pregnancy, chronic HTN, gestational HTN, pre-eclampsia, and eclampsia drive preventable maternal deaths through stroke, pulmonary edema, renal failure, HELLP syndrome, and multisystem organ dysfunction. This review synthesizes evidence on (i) the burden and patterns of maternal mortality in West Africa, (ii) mechanistic links between HTN/HDP and maternal death, (iii) contextual determinants (the “3 delays,” quality of care, referral pathways, and commodity readiness), and (iv) high-impact interventions—from antenatal risk detection to emergency management (MgSO₄, rapid BP control, timely delivery). We highlight implementation gaps and propose a pragmatic, West Africa–adapted action agenda to reduce HDP-related mortality. Keywords: West Africa, maternal mortality, hypertension, pre-eclampsia, eclampsia, HELLP, magnesium sulfate, emergency obstetric care.