Community perceptions of pre-eclampsia and eclampsia in southern Mozambique

Boene, Helena; Vidler, Marianne; Sacoor, Charfudin; Nhama, Abel; Nhacolo, Ariel; Bique, Cassimo; Alonso, Pedro L.; Sawchuck, Diane; Qureshi, Rahat; Macete, Eusébio; Menéndez, Clara; Dadelszen, Peter von; Sevene, Esperança; Munguambe, Khátia

doi:10.1186/s12978-016-0135-y

Cited by 29 publications

(51 citation statements)

References 8 publications

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“…Sub-Saharan Africa has the highest maternal mortality ratio at 500 per 100,000 live births 5. In Zimbabwe, preeclampsia and eclampsia are the third leading causes of death after AIDS-defining conditions and postpartum hemorrhage 6.…”

Section: Introductionmentioning

confidence: 99%

Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe

Ngwenya¹

2017

IJWH

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BackgroundSevere preeclampsia is a disorder of pregnancy characterized by high blood pressure and significant proteinuria after 20 weeks gestation. Severe preeclampsia and eclampsia have considerable adverse impacts on maternal, fetal, and neonatal health especially in low-resource countries. Hypertensive disorders of pregnancy are the third leading cause of maternal deaths in Sub-Saharan Africa. Significant avoidable maternal and neonatal morbidity and mortality may result.ObjectivesThis study aimed 1) to determine the incidence of severe preeclampsia/eclampsia in a low-resource setting; 2) to determine the maternal complications of severe preeclampsia/eclampsia in a low-resource setting; 3) to determine the perinatal outcomes of severe preeclampsia/eclampsia in a low-resource setting.MethodsThis was a retrospective descriptive cohort study carried out at Mpilo Central Hospital, a tertiary teaching referral government hospital in a low-resource setting in Bulawayo, Zimbabwe. Data were obtained from the birth registers in labor ward, intensive care unit, and neonatal intensive care unit of patients who had a diagnosis of severe preeclampsia or eclampsia for the period January 1, 2016, to December 31, 2016. The case notes were retrieved and the demographic, clinical, and outcome data were gathered.ResultsThere were 9,086 deliveries at the institution during the period January 1, 2016, to December 31, 2016. There were 121 cases of severe preeclampsia/eclampsia. The incidence of severe preeclampsia/eclampsia was 1.3% at Mpilo Central Hospital. The most common major complication was HELLP syndrome (9.1%). Maternal mortality was 1.7%. There were 127 babies born with six sets of twins, 49.6% of the babies were lost through stillbirths and early neonatal deaths.ConclusionThe incidence of severe preeclampsia/eclampsia at Mpilo Central Hospital was 1.3%. The most common maternal complication was hemolysis elevated liver enzymes low platelet syndrome. Maternal mortality was 1.7% due to acute renal failure. Nearly half (49.6%) of the babies born were lost to stillbirths and early neonatal deaths.

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Section: Introductionmentioning

confidence: 99%

Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe

Ngwenya¹

2017

IJWH

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“…In Mozambique, such limitations include poor access to diagnostic testing as mentioned above, as well as limited knowledge of preeclampsia and delays in seeking care. [15][16][17][18] In response to the gaps in care discussed above, we determined the ability of maternal plasma-free PlGF to identify those women at risk of complicated preeclampsia when preeclampsia was suspected in the course of antenatal care in Maputo city, Mozambique.…”

Section: Hypertensionmentioning

confidence: 99%

Diagnostic Performance of Placental Growth Factor in Women With Suspected Preeclampsia Attending Antenatal Facilities in Maputo, Mozambique

et al. 2017

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C omplicating an estimated 3% to 10% of pregnancies, the hypertensive disorders of pregnancy account for an estimated 46,000 maternal and 500,000 perinatal deaths annually, with >99% of these deaths occurring in less-developed countries, including Mozambique.1,2 The most dangerous of the hypertensive disorders of pregnancy is preeclampsia, the origins of which lie in a mixture of maternal and placental factors.3,4 Currently, delivery is the only mechanism by which to initiate the resolution of preeclampsia, 3 whether that delivery is spontaneous or iatrogenic. Iatrogenic delivery is predicated on a timely diagnosis of preeclampsia, with additional safeguards being offered through avoidance of, and response to, severe maternal hypertension and eclampsia for women and risks of prematurity for fetuses before term. 1The diagnosis of the hypertensive disorders of pregnancy, especially preeclampsia, largely remains reliant on women having access to accurate blood pressure (BP) measurement, estimation of urinary protein, and testing for end organ complications. Women in their community and admitted to hospital with a hypertensive disorders of pregnancy can be assessed for actuarial risk using either the demographics-, symptom-, and sign-based miniPIERS (Pre-Eclampsia Integrated Estimate of Risk) tool, especially when supplemented by pulse oximetry 5,6 or the demographics-, symptom-, sign-, and laboratory testbased fullPIERS tool. 7In well-resourced settings, low concentrations of circulating maternal-free placental growth factor (PlGF) (sometimes relative to soluble fms-like tyrosine kinase-1) or antiangiogenic See Editorial Commentary, pp 401-403Abstract-In well-resourced settings, reduced circulating maternal-free placental growth factor (PlGF) aids in either predicting or confirming the diagnosis of preeclampsia, fetal growth restriction, stillbirth, preterm birth, and delivery within 14 days of testing when preeclampsia is suspected. This blinded, prospective cohort study of maternal plasma PlGF in women with suspected preeclampsia was conducted in antenatal clinics in Maputo, Mozambique. The primary outcome was the clinic-to-delivery interval. Other outcomes included: confirmed diagnosis of preeclampsia, transfer to higher care, mode of delivery, intrauterine fetal death, preterm birth, and low birth weight. Of 696 women, 95 (13.6%) and 601 (86.4%) women had either low (<100 pg/mL) or normal (≥100 pg/mL) plasma PlGF, respectively. The clinicto-delivery interval was shorter in low PlGF, compared with normal PlGF, women (median 24 days [interquartile range, 10-49] versus 44 , P=0.0042). Also, low PlGF was associated with a confirmed diagnosis of preeclampsia, higher blood pressure, transfer for higher care, earlier gestational age delivery, delivery within 7 and 14 days, preterm birth, cesarean delivery, lower birth weight, and perinatal loss. In urban Mozambican women with symptoms or signs suggestive of preeclampsia, low maternal plasma PlGF concentrations are associated with increased risks of adverse pregnancy o...

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“…This finding was identical to other studies in Africa and Asia. 3,[10][11][12] Only 15% of women knew that preeclampsia was a pathology specific to pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…In most developing countries, women and the community believe that high blood pressure during pregnancy is due to a stress of everyday life. 3,[10][11][12] In India, Vidler et al, reported that dietary deficiency stress is the main cause cited by patients. 10 In Mozambique, stress and conflict with the in-laws would be the causes according to the patients.…”

Section: Discussionmentioning

confidence: 99%

The women knowledge, attitude, and perceptions of pre-eclampsia and eclampsia in Madagascar

Romuald

Ratsiatosika

Martial

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Preeclampsia is a complication of pregnancy responsible for high rates of morbidity and mortality, particularly in Africa and Madagascar. The objective of present study was to assess patients' knowledge, attitudes and beliefs about pre-eclampsia in Madagascar.Methods: This is an observational study on the knowledge, belief and attitudes of women seen at the Befelatanana Gynecology and Obstetrics Hospital and conducted by questionnaires from 1 December 2017 to 30 May 2018.Results: During the study period, 102 patients agreed to answer our questionnaire. Terminology exists in the local language to describe convulsions and hypertension, but there were no terms that are specific to pregnancy. More than half of our patients knew preeclampsia. In 41% of cases, patients attributed excessive salt intake as a cause of high blood pressure during pregnancy and in 20% secondary to stress. Headache was the best-known symptom of patients. Signs of danger such as epigastric pain, genital bleeding, visual disturbances, convulsions and decreased sensation of fetal movements are not well known to patients. One-third did not know it was lethal. Regarding fetal complications, the occurrence of fetal death in utero was the best known. The majority of patients were aware that blood pressure measurements and urine dipstick testing were mandatory during pregnancy follow-up. To prevent preeclampsia, 46.07% thought that reducing salt intake would reduce the occurrence of preeclampsia.Conclusions: Few patients are aware of preeclampsia, its danger signs and its complications, especially during prenatal consultation. This requires the improvement of knowledge of all health actor. Community health workers should receive basic and ongoing training to facilitate dialogue and information for pregnant and non-pregnant women in each society.

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Community perceptions of pre-eclampsia and eclampsia in southern Mozambique

Cited by 29 publications

References 8 publications

Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe

Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe

Diagnostic Performance of Placental Growth Factor in Women With Suspected Preeclampsia Attending Antenatal Facilities in Maputo, Mozambique

The women knowledge, attitude, and perceptions of pre-eclampsia and eclampsia in Madagascar

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