Aims: The first appointment a pregnant woman makes to the antenatal unit of a hospital is often called the Booking Visit (BV). This visit happens towards the end of the first trimester, usually between 8–14 weeks. The medical, obstetric and family history of the woman are taken. This helps to determine the potential for any risks that may occur during the pregnancy and thus allow appropriate medical intervention. Preeclampsia is a multisystem disease of pregnancy of unknown cause. The only effective therapy is to facilitate the delivery. Preeclampsia is also an important cause of maternal and perinatal morbidity and mortality. The aim of this study was to determine whether the timing of the visit has any effect on the occurrence of preeclampsia.

Methods: This case - control study was used to recruit a total of 400 primigravida in the second trimester of their pregnancy, comprising two hundred women with preeclampsia (cases) and two hundred age-matched normotensive pregnant women (controls) visiting the Obstetrics and Gynaecology Departments of the KomfoAnokye Teaching Hospital in Kumasi and Ridge Regional Hospital in Accra both in Ghana. The diagnosis of preeclampsia was assessed by a qualified Obstetrician/Gynaecologist at the respective hospitals. The booking visit was abstracted from the medical records of the recruited pregnant women. Urine sample was obtained for the analysis of urine protein and microalbuminuria and blood sample for hemoglobin, calcium and magnesium.

Results: The mean gestation of the cases was significantly higher than that of the controls, p < 0.0001. More than 70% of the cases with serum magnesium less than 0.7 mmol/l had BV between 17–24 weeks compared to the control. Also, significant portion (71.5%) of the cases had serum calcium levels below 2.1 mmol/l and were found to have BV between 17–24 weeks compare to 11.1% of the controls with normal calcium levels. Preeclamptic individuals with hemoglobin (Hb) less than 11.0 g/dl reported to the hospital between 17–24 weeks compared to 20% of the controls. Women (9.1 %) diagnosed with anaemia reported to the hospitals after 24 weeks of gestation. More than 50% of the cases were uneducated and only 1% had tertiary education. Conclusion: The current study reports a significantly late booking visit in women with preeclampsia and this as well as luck of education may play a role in the development of preeclampsia.

Keywords: Calcium, Hemoglobin, Magnesium, Microalbuminuria, Proteinuria