P 4 Diagnosis, management and care of hypertensive disorders of pregnancy (HDP) in India – An Indian expert opinion

Pal, Bhaskar; Biniwale, Parag; Sundari, Tripura; Govindarajan, Mirudhubashini; Kannan, Jayam; Mandrupkar, Gorakh; Datar, Nikhil; Balamba, P.; Bhandiwad, Ambarisha; Mane, Sheela; Chandravati, G.; Pandya, Manish R; Vyas, Leela; Goel, Sugandh; Khurana, Amandeep; Motlekar, Salman; Qamra, Amit; Barkate, Hanmant; Deshpande, Hemant

doi:10.1016/j.preghy.2017.07.083

Cited by 3 publications

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“…Penilaian Kesadaran manajemen ibu dan dukungan keluarga selama kehamilan seperti kesadaran untuk memeriksakan diri selama kehamilan yang masih kurang dapat menimbulkan peningkatan komplikasi pada ibu yang sudah memiliki riwayat hipertensi atau penyakit lain dalam kehamilan (Pal et al, 2017) Untuk itu, keikutsertaan ibu dalam penerapan P4K perlu dilukan dalam pencegahan penyebaran ataupun peningkatan komplikasi pada masa kehamilan.…”

Section: Latar Belakangunclassified

Implementasi Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4k) Kaitannya Dengan Penyebab Kematian Maternal

Putri,

Yunita,

Kurniawan

et al. 2023

kjik

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Latar belakang: Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) adalah sebuah program pemerintah yang bertujuan untuk mendorong percepatan penurunan Angka Kematian Ibu (AKI). Apabila cakupan ibu hamil yang memperoleh parameter pemantauan P4K sampai dengan 80%, maka diharapkan angka kematian ibu yang diakibatkan oleh komplikasi dapat menurun hingga 6000 jiwa dari 2.052.000 per tahunnya. Penelitian ini bertujuan untuk menganalisis Penerapan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) terhadap penyebab kematian ibu. Subyek dan metode: penelitian ini merupakan penelitian analitik dengan desain studi kohort retrospektif yang dilakukan pada 34 Provinsi di Indonesia pada tahun 2019. Besar sampel sebesar 9472 puskesmas di Indonesia. Variabel dependen adalah Penerapan Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K). Variabel independen antara lain perdarahan, hipertensi dalam kehamilan, infeksi, gangguan sistem peredaran darah, dan gangguan metabolik. Pengumpulan data menggunakan data sekunder dan dianalisis menggunakan regresi linier berganda. Hasil penelitian: perdarahan (b= 6.55; 95% CI= 2.81 to 10.29; p=0.001), hipertensi dalam kehamilan (b= 0.79; 95% CI= -2.11 to 3.69; p= 0.583), meningkatkan keikutsertaan Penerapan P4K. Rendahnya variabel lain, seperti infeksi (b= -1.33; 95% CI= -10.87 to 8.20; p= 0.777), gangguan system peredaran darah (b= -8.95; 95% CI= -13.50 to -4.40; p=<0.001), gangguan metabolik (b= -0.27; 95% CI= -4.75 to 4.21; p=0.903) akan menurunkan keikutsertaan Penerapan P4K. Keikutsertaan ibu dalam Penerapan P4K akan membantu menurunkan komplikasi dalam kehamilan, seperti perdarahan, hipertensi dalam kehamilan, infeksi, gangguan sistem peredaran darah dan gangguan metabolik. Kata kunci: kematian maternal, program perencanaan persalinan dan pencegahan komplikasi, puskesmas Background: The Delivery Planning and Complication Prevention Program (P4K) is a government program that aims to accelerate the reduction of the Maternal Mortality Rate (MMR). If the coverage of pregnant women receiving P4K monitoring parameters is up to 80%, it is expected that the maternal mortality rate caused by complications can decrease to 6,000 people from 2,052,000 per year. This study aims to analyze the implementation of the Birth Planning and Complication Prevention Program (P4K) on the causes of maternal death. Subjects and method: this research is an analytical study with a retrospective cohort study design which was conducted in 34 provinces in Indonesia in 2019. The sample size is 9472 puskesmas in Indonesia. The dependent variable is the Implementation of the Birth Planning and Complication Prevention Program (P4K). Independent variables include bleeding, hypertension in pregnancy, infection, circulatory system disorders, and metabolic disorders. Data collection uses secondary data and is analyzed using multiple linear regression. Result: bleeding (b= 6.55; 95% CI= 2.81 to 10.29; p= 0.001), hypertension in pregnancy (b= 0.79; 95% CI= -2.11 to 3.69; p= 0.583), increasing the participation of P4K implementation. Low other variables, such as infection (b= -1.33; 95% CI= -10.87 to 8.20; p= 0.777), circulatory system disorders (b= -8.95; 95% CI= -13.50 to -4.40; p=<0.001), metabolic disorders (b= -0.27; 95% CI= -4.75 to 4.21; p=0.903) will reduce the participation in implementing P4K. Mothers’ participation in implementing P4K will help reduce complications in pregnancy, such as bleeding, hypertension in pregnancy, infection, circulatory system disorders, and metabolic disorders. Keywords: delivery planning and complication prevention programs, health centers, maternal mortality

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Section: Latar Belakangunclassified

Implementasi Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4k) Kaitannya Dengan Penyebab Kematian Maternal

Putri,

Yunita,

Kurniawan

et al. 2023

kjik

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“…9 Though treating HDP does not alter the progression of disease, early management decreases not only the frequency of hypertensive complications, but also the rate of neonatal complications. 10 (Table 1) tabulates some of the studies on HDP that have been conducted in India. However, there is no specific document that can serve as a guide to the gynecologists and obstetricians.…”

Section: Why India Needs a Guiding Tool For Hdp?mentioning

confidence: 99%

Diagnosis, management and care of hypertensive disorders of pregnancy (HDP): An Indian Expert Opinion

Motlekar¹,

Pal²,

Biniwale³

et al. 2021

IJOGR

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Guidelines—similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension

Scott

Gillon

Pels

et al. 2022

American Journal of Obstetrics and Gynecology

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This study aimed to review pregnancy hypertension clinical practice guidelines to inform international clinical practice and research priorities. STUDY ELIGIBILITY CRITERIA: Relevant national and international clinical practice guidelines, 2009-19, published in English, French, Dutch or German. STUDY APPRAISAL AND SYNTHESIS METHODS: Following published methods and prospective registration (CRD42019123787), a literature search was updated. CPGs were identified by 2 authors independently who scored quality and usefulness for practice (Appraisal of Guidelines for Research and Evaluation II instrument), abstracted data, and resolved any disagreement by consensus. RESULTS: Of note, 15 of 17 identified clinical practice guidelines (4 international) were deemed "clinically useful" and had recommendations abstracted. The highest Appraisal of Guidelines for Research and Evaluation II scores were from government organizations, and scores have improved over time. The following were consistently recommended: (1) automated blood pressure measurement with devices validated for pregnancy and preeclampsia, reflecting increasing recognition of the prevalence of white-coat hypertension and the potential usefulness of home blood pressure monitoring; (2) use of dipstick proteinuria testing for screening followed by quantitative testing by urinary protein-to-creatinine ratio or 24-hour urine collection; (3) key definitions and most aspects of classification, including a broad definition of preeclampsia (which includes proteinuria and maternal end-organ dysfunction, including headache and visual symptoms and laboratory abnormalities of platelets, creatinine, or liver enzymes) and a recognition that it can worsen after delivery; (4) preeclampsia prevention with aspirin; (5) treatment of severe hypertension, most commonly with intravenous labetalol, oral nifedipine, or intravenous hydralazine; (6) treatment for nonsevere hypertension when undertaken, with oral labetalol (in particular), methyldopa, or nifedipine, with recommendations against the use of renin-angiotensin-aldosterone inhibitors; (7) magnesium sulfate for eclampsia treatment and prevention among women with "severe" preeclampsia; (8) antenatal corticosteroids for preterm birth but not hemolysis, elevated liver enzymes, and low platelet count syndrome; (9) delivery at term for preeclampsia; (10) a focus on usual labor and delivery care but avoidance of ergometrine; and (11) an appreciation that long-term health complications are increased in incidence, mandating lifestyle change and risk factor modification. Lack of uniformity was seen in the following areas: (1) the components of a broad preeclampsia definition (specifically respiratory and gastrointestinal symptoms, fetal manifestations, and biomarkers), what constitutes severe preeclampsia, and whether the definition has utility because at present what constitutes severe preeclampsia by some guidelines that mandate proteinuria now defines any preeclampsia for most other clinical practice guidelines; (2) how preeclampsia r...

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P 4 Diagnosis, management and care of hypertensive disorders of pregnancy (HDP) in India – An Indian expert opinion

Cited by 3 publications

References 0 publications

Implementasi Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4k) Kaitannya Dengan Penyebab Kematian Maternal

Implementasi Program Perencanaan Persalinan Dan Pencegahan Komplikasi (P4k) Kaitannya Dengan Penyebab Kematian Maternal

Diagnosis, management and care of hypertensive disorders of pregnancy (HDP): An Indian Expert Opinion

Guidelines—similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension

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