Pre-eclampsia in low and middle income countries

Firoz, Tabassum; Sanghvi, Harshad; Merialdi, Mario; Dadelszen, Peter von

doi:10.1016/j.bpobgyn.2011.04.002

Cited by 111 publications

(102 citation statements)

References 14 publications

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“…Of the 10 countries that represent 60% of maternal mortality (i.e., India, Nigeria, Democratic Republic of the Congo, Sudan, Pakistan, Indonesia, Ethiopia, Tanzania, Bangladesh, and Afghanistan), all had accessible EMLs, all of which were included in our study. 5,14 The great majority of LMICs in South Asia, the Middle East, and North Africa had identi able EMLs. Most countries in Eastern Europe and Central Asia did not have identi able EMLs.…”

Section: Geographica and Income Distribution Of Identi Ed Emls In 14mentioning

confidence: 99%

“…[28][29][30][31] The majority of these women (approximately 75%) will require antihypertensive therapy even while on magnesium sulphate and approximately 50% will require rapid-acting medication to lower BP acutely. 5,16 There is a lack of data with respect to the listing of labour induction therapies in EMLs. On the basis of existing evidence, it would seem appropriate that oral misoprostol is the most commonly listed prostanoid on EMLs.…”

Section: Geographica and Income Distribution Of Identi Ed Emls In 14mentioning

confidence: 99%

“…4 Ninety-nine percent of maternal deaths related to preeclampsia occur in low and middle income countries, where the case fatality rate is ve times higher than in wellresourced countries. 2,5 The majority of these preeclampsiarelated events have been attributed to delays in three aspects of care: triage, transport, and treatment. 5 Pharmacological management of preeclampsia has ve major components, depending on an individual woman's clinical presentation and the severity of her condition:…”

Section: Introductionmentioning

confidence: 99%

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Pharmacotherapy for Preeclampsia in Low and Middle Income Countries: An Analysis of Essential Medicines Lists

Lalani

Firoz

Magee

et al. 2013

Journal of Obstetrics and Gynaecology Canada

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Objective: To determine the prevalence of drugs for comprehensive management of preeclampsia in national essential medicine lists (EMLs) in low and middle income countries (LMICs) Methods:We collected EMLs from the 144 LMICs identi ed by the World Bank through broad-based Internet searches and in collaboration with the World Health Organization We identi ed therapies for hypertension, eclampsia, preeclampsia complications (eg, pulmonary edema, thrombosis), preterm birth, and labour induction contained in the EMLs Resuts:In 91 EMLs obtained from 144 LMICs, the most commonly listed parenteral antihypertensive therapies were verapamil (637%), hydralazine (615%), sodium nitroprusside (483%), and propranolol (396%) The most prevalent oral antihypertensive therapies were nifedipine (956%), methyldopa (934%), propranolol (901%), and atenolol (879%) For eclampsia/ preeclampsia, magnesium sulphate was present in 846% of EMLs and calcium gluconate in 857% For pulmonary edema, most EMLs (945%) listed oral furosemide, for thrombosis 923% listed heparin, for acceleration of fetal pulmonary maturity 901% listed parenteral dexamethasone, and for labour induction 978% listed oxytocin or a prostanoid (usually misoprostol, 407%) Concusion: EMLs of LMICs provide comprehensive coverage of preeclampsia pharmacotherapy These EMLs may be used as advocacy tools to ensure the availability of these therapies within each country RésuméObjectif : Déterminer la prévalence des médicaments permettant la prise en charge exhaustive de la prééclampsie au sein des listes de médicaments essentiels (LME) nationales des pays ne disposant que d'un revenu faible ou moyen (PRFM)Méthodes : Nous avons regroupé les LME des 144 PRFM identi és par la Banque mondiale par l'intermédiaire de recherches généralisées sur Internet et en collaboration avec l'Organisation mondiale de la santé Nous avons identi é, au sein des LME, les traitements visant l'hypertension, l'éclampsie, les complications de la prééclampsie (p ex oedème pulmonaire, thrombose), l'accouchement préterme et le déclenchement du travailRésutats : Au sein des 91 LME obtenues auprès de 144 PRFM, les traitements antihypertenseurs parentéraux apparaissant le plus couramment ont été les suivants : vérapamil (63,7 %), hydralazine (61,5 %), nitroprussiate de sodium (48,3 %) et propranolol (39,6 %) Les traitements antihypertenseurs oraux les plus prévalents ont été les suivants : nifédipine (95,6 %), méthyldopa 216 l MARCH JOGC MARS 2013 OBSTETRICS (93,4 %), propranolol (90,1 %) et aténolol (87,9 %) Pour ce qui est de l'éclampsie / la prééclampsie, le sulfate de magnésium gurait dans 84,6 % des LME et le gluconate de calcium, dans 85,7 % de celles-ci Pour ce qui est de l'oedème pulmonaire, le furosémide oral gurait dans la plupart des LME (94,5 %); pour ce qui est de la thrombose, l'héparine gurait dans 92,3 % des LME; pour ce qui est de l'accélération de la maturité pulmonaire foetale, la dexaméthasone parentérale gurait dans 90,1 % des LME; et pour ce qui es...

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Section: Geographica and Income Distribution Of Identi Ed Emls In 14mentioning

confidence: 99%

Section: Geographica and Income Distribution Of Identi Ed Emls In 14mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pharmacotherapy for Preeclampsia in Low and Middle Income Countries: An Analysis of Essential Medicines Lists

Lalani

Firoz

Magee

et al. 2013

Journal of Obstetrics and Gynaecology Canada

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“…Access to healthcare, distance and costs are additional obstacles faced by women in middle and lower income countries (LMIC). 24 Currently the most reliable method of identification of pre-eclampsia is early recognition of the disease during ante-natal care. However some patients may develop a sudden acute hypertensive emergency.…”

Section: Resultsmentioning

confidence: 99%

Early Detection Of Preeclampsia

Arnaud¹

2013

Chem. Eng. News Archive

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Pre-eclampsia is a major cause of maternal and perinatal morbidity and mortality. The current recommended screening approach is to identify risk factors from maternal history and demographic characteristics. Blood pressure and urinary proteins must be determined at every ante-natal visit. Patients with gestational hypertension and/or gestational proteinuria require increased antenatal surveillance because they have an increased risk for developing pre-eclampsia during pregnancy. We recommend that these patients be considered for management at District level. Local protocols must in place for emergency treatment and referral of patients who develop a sudden acute hypertensive emergency.

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“…1 These deaths are thought to be due to delays in case identification and a shortage of health workers trained to manage the disorder. 2 In the past 20 years, some progress has been made in reducing preeclampsia-related maternal deaths (an estimated 69 800 in 1990 vs. 47 100 in 2010). 1 To maintain this progress, innovative tools to improve management of the condition are required.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Incremental Value of Blood Oxygen Saturation (SpO2) in the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) Risk Prediction Model

Payne

Hutcheon

Dunsmuir

et al. 2015

Journal of Obstetrics and Gynaecology Canada

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Objective: To assess the incremental value of blood oxygen saturation (SpO 2 ) as a predictor in the miniPIERS model, a risk prediction model for adverse outcomes among women with a diagnosis of hypertensive disorder of pregnancy (HDP) in lowresourced settings .Methods: Using data from a prospective cohort including 852 women admitted to hospital for a HDP, the association between SpO 2 and adverse maternal outcome was assessed using logistic regression . The miniPIERS model was recalibrated and extended to include SpO 2 . The incremental value of adding SpO 2 to the model was measured using a net reclassification index (NRI), sensitivity, specificity, positive and negative predictive values, and likelihood ratios .Results: SpO 2 of < 93% was associated with a 30-fold increase in risk (95% CI 14 to 68) of adverse maternal outcome compared to women with SpO 2 > 97% . After recalibration and extension, the miniPIERS model including SpO 2 (vs . not including SpO 2 ) had improved sensitivity (32 .8% vs . 49 .6%) at the cost of minimally decreased specificity (91.5% vs. 96.2%) with a NRI of 0.122. Conclusion:SpO 2 is a significant independent predictor of risk in women with a HDP . Adding SpO 2 to the miniPIERS model improved the model's ability to correctly identify high-risk patients who would benefit most from interventions. RésuméObjectif : Évaluer la valeur cumulative de la saturation en oxygène (SaO 2 ) à titre de facteur prédictif dans le cadre du modèle miniPIERS, soit un modèle de prévision des risques en ce qui concerne les issues indésirables chez les femmes ayant obtenu un diagnostic de trouble hypertensif de la grossesse (THG) dans des milieux qui ne disposent que de faibles ressources . Méthodes

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Pre-eclampsia in low and middle income countries

Cited by 111 publications

References 14 publications

Pharmacotherapy for Preeclampsia in Low and Middle Income Countries: An Analysis of Essential Medicines Lists

Pharmacotherapy for Preeclampsia in Low and Middle Income Countries: An Analysis of Essential Medicines Lists

Early Detection Of Preeclampsia

Assessing the Incremental Value of Blood Oxygen Saturation (SpO2) in the miniPIERS (Pre-eclampsia Integrated Estimate of RiSk) Risk Prediction Model

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