Pre-eclampsia in low and middle income countries.
نویسندگان
چکیده
Pre-eclampsia and eclampsia are leading causes of maternal and perinatal morbidity and mortality worldwide. The exact prevalence, however, is unknown. The majority of pre-eclampsia related deaths in LMIC occur in the community and therefore, interventions must be focused at this level. There are a number of unique challenges facing LMIC but the principles of care for women with pre-eclampsia remain the same as in well resourced settings. Three primary delays lead to an increased incidence of maternal mortality from pre-eclampsia- delays in triage, transport and treatment. There are a number of other challenges facing LMIC and the health care worker shortage is particularly significant. Task shifting is a potential strategy to address this challenge. Community health care workers, specifically lady health care workers, are an integral part of the health care force in many LMIC and can be employed to provide timely care to women with pre-eclampsia. Prevention strategies should be applied to every pregnant woman since we cannot predict who will develop pre-eclampsia given the limitation in resources. Aspirin and calcium are the only two recommended therapies at this time. Measuring blood pressure and proteinuria is challenging in LMIC due to financial cost and lack of training. A detection tool that is affordable and can be easily applied is needed. Magnesium sulfate is the drug of choice for the prevention and treatment of eclampsia but it is underutilized due to barriers on multiple levels.
منابع مشابه
PRE-EMPT (PRE-eclampsia-Eclampsia Monitoring, Prevention and Treatment): A low and middle income country initiative to reduce the global burden of maternal, fetal and infant death and disease related to pre-eclampsia
Pre-eclampsia is associated with an unacceptable burden of death (maternal, fetal and neonatal), disability and health crises throughout the world [1]. However, it is in low and middle income countries (LMICs) that women, their families and their communities bear a disproportionate risk for developing the life-ending, life-threatening, and life-altering complications of pre-eclampsia; it is bel...
متن کاملPreeclampsia in low and middle income countries-health services lessons learned from the PRE-EMPT (PRE-Eclampsia-Eclampsia Monitoring, Prevention and Treatment) project.
The hypertensive disorders of pregnancy, in particular preeclampsia, matter because adverse events occur in women with preeclampsia and, to a lesser extent, in women with the other hypertensive disorders. These adverse events are maternal, perinatal, and neonatal and can alter the life trajectory of each individual, should that life not be ended by complications. In this review we discuss a num...
متن کاملRisk Factors of Pre-Eclampsia/Eclampsia and Its Adverse Outcomes in Low- and Middle-Income Countries: A WHO Secondary Analysis
BACKGROUND Pre-eclampsia has an immense adverse impact on maternal and perinatal health especially in low- and middle-income settings. We aimed to estimate the associations between pre-eclampsia/eclampsia and its risk factors, and adverse maternal and perinatal outcomes. METHODS We performed a secondary analysis of the WHO Global Survey on Maternal and Perinatal Health. The survey was a multi...
متن کاملEvolution of Magnesium Sulphate for Eclampsia
Eclampsia is said to occur when a woman with preeclampsia experiences generalised tonic-clonic seizures during pregnancy or shortly after delivery [1]. Eclampsia complicates between 1 to 2% of all cases of severe preeclampsia [2]. Preeclampsia is a multi-systemic disorder, characterised by hypertension and proteinuria occurring after the 20th week of pregnancy in a woman who has been previously...
متن کاملEvolution of Magnesium Sulphate for Eclampsia
Eclampsia is said to occur when a woman with preeclampsia experiences generalised tonic-clonic seizures during pregnancy or shortly after delivery [1]. Eclampsia complicates between 1 to 2% of all cases of severe preeclampsia [2]. Preeclampsia is a multi-systemic disorder, characterised by hypertension and proteinuria occurring after the 20th week of pregnancy in a woman who has been previously...
متن کاملAdvocacy is essential to supporting women with pre-eclampsia.
Advocacy has a critical role in advancing the maternal health agenda. Patient advocacy groups can hold governments and other stakeholders accountable and ensure that commitments are translated into concrete action. This article highlights the advocacy efforts of the Preeclampsia Foundation, a patient advocacy organisation that aims to improve the diagnosis, management, and prevention of pre-ecl...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Best practice & research. Clinical obstetrics & gynaecology
دوره 25 4 شماره
صفحات -
تاریخ انتشار 2011