Reducing maternal mortality from preeclampsia and eclampsia in low‐resource countries – what should work?

Goldenberg, Robert L.; Jones, Bonnie; Griffin, Jennifer B.; Rouse, Doris J.; Kamath‐Rayne, Beena D.; Trivedi, Nehal; McClure, Elizabeth M

doi:10.1111/aogs.12533

Cited by 48 publications

(61 citation statements)

References 22 publications

(34 reference statements)

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“…The information provided by this research can serve as model to improve maternal health care in our country or other developing ones with similar settings. We propose a) improvement of adequacy of prenatal care;28 b) enhancement of reproductive health education to teens (boys and girls) and c) the promotion of the protection of girl’s rights and eradication of intimate partner violence and the risk of undesired pregnancies. Socialization of women’s rights and their roles in the society should be a worldwide priority, at the same level of males.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes in younger and older adolescent mothers with severe preeclampsia

Parra-Pingel¹,

Quisiguiña-Avellán²,

Hidalgo³

et al. 2017

AHMT

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BackgroundAdolescent mothers are at higher risk for preeclampsia, but the effect of their age on the outcome of the pregnancy complication is not clear.ObjectiveTo describe maternal and neonatal outcomes among singleton adolescent pregnancies complicated with severe preeclampsia in a low-income-setting hospital and compare results according to age.Materials and methodsMaternal and neonatal outcomes of 213 adolescent mothers complicated with severe preeclampsia delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital (Guayaquil, Ecuador) were analyzed and compared according to their age (16 or less years, n=82 vs 17–19 years, n=131).ResultsCesarean section rate was high in both studied groups; otherwise, obstetrical outcome did not differ and there were no maternal deaths or severe complications. Neonatal outcome was adverse in the two groups evidenced by high rates of preterm birth, small-for-gestational-age and low-birth-weight infants, low first-minute Apgar scores and admissions to neonatal intensive care; however, it was not significantly different between the analyzed groups. There were no neonatal deaths among mothers aged 16 or less and 4 in the group aged 17–19 years. This was, however, not significant (p=0.30).ConclusionPregnancy outcome in this adolescent population with severe preeclampsia was similarly adverse, independent of maternal age.

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Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes in younger and older adolescent mothers with severe preeclampsia

Parra-Pingel¹,

Quisiguiña-Avellán²,

Hidalgo³

et al. 2017

AHMT

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“…[26] 2012 PE is thought to account for about 15% of maternal mortality worldwide, between 20% and 25% of fetal mortality, and with increased risk of asphyxia and preterm delivery for as much as 25% of neonatal mortality.…”

Section: Preeclampsia Diseasementioning

confidence: 99%

Fuzzy Intelligent System for Patients with Preeclampsia in Wearable Devices

Espinilla

Medina

García-Fernández

et al. 2017

Mobile Information Systems

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Preeclampsia affects from 5% to 14% of all pregnant women and is responsible for about 14% of maternal deaths per year in the world. This paper is focused on the use of a decision analysis tool for the early detection of preeclampsia in women at risk. This tool applies a fuzzy linguistic approach implemented in a wearable device. In order to develop this tool, a real dataset containing data of pregnant women with high risk of preeclampsia from a health center has been analyzed, and a fuzzy linguistic methodology with two main phases is used. Firstly, linguistic transformation is applied to the dataset to increase the interpretability and flexibility in the analysis of preeclampsia. Secondly, knowledge extraction is done by means of inferring rules using decision trees to classify the dataset. The obtained linguistic rules provide understandable monitoring of preeclampsia based on wearable applications and devices. Furthermore, this paper not only introduces the proposed methodology, but also presents a wearable application prototype which applies the rules inferred from the fuzzy decision tree to detect preeclampsia in women at risk. The proposed methodology and the developed wearable application can be easily adapted to other contexts such as diabetes or hypertension.

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“…Pre‐eclampsia, defined as new‐onset hypertension after 20 weeks of pregnancy with signs of end‐organ dysfunction, is a major worldwide cause of maternal mortality, stillbirth, and neonatal morbidity such as asphyxia and prematurity . With advances in obstetric care in high‐income countries, such adverse outcomes from pre‐eclampsia are concentrated in low‐income countries . From 1990 to 2010, as stated in the Global Burden of Disease study, maternal hypertension became, or remained, the second leading cause of maternal death in Honduras, Nicaragua, and Belize…”

Section: Introductionmentioning

confidence: 99%

“…With the rise in the number of deliveries occurring at health facilities in low‐income countries, quality of care and multidimensional management for pre‐eclampsia are gaining attention . Interventions are expanding beyond critical, single interventions such as magnesium sulfate administration .…”

Section: Introductionmentioning

confidence: 99%

Assessing multidimensional care coverage for pre‐eclampsia in the era of universal health coverage: A pre–post evaluation of the Salud Mesoamérica Initiative

Kamath

Johanns

Thom

et al. 2020

Intl J Gynecology & Obste

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Objective: To compare a multidimensional care package for pre-eclampsia/eclampsia in Central American health facilities, before and after implementation of the Salud Mesoamérica Initiative. Methods: An evaluation study was conducted at 67 basic-and comprehensive-level health facilities serving the poorest areas in Honduras, Nicaragua, and Belize. Cases of severe pre-eclampsia or eclampsia were randomly sampled and relevant quality of care data extracted from medical records at baseline (n=111) from January 1, 2011, to March 31, 2013, and at second-phase follow-up (n=249) from June 1, 2015, to September 30, 2017. The primary outcome was evidence of the delivery of multidimensional care for the management of pre-eclampsia/eclampsia. Results: The care of 360 women with severe pre-eclampsia or eclampsia was analyzed. Odds of multidimensional care for pre-eclampsia management (P=0.271) increased (although not significantly) in the second-phase follow-up compared to baseline. Multidimensional care was significantly associated with training (P<0.001), basic-level facilities (P<0.001), and higher in Honduras (P=0.001) and Belize (P=0.024) than the reference country of Nicaragua. Conclusion: Multidimensional care for pre-eclampsia management increased across all facility types, countries, and severity of disease. The Salud Mesoamérica Initiative is a promising model for achieving such quality of care interventions in the era of universal health coverage.

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Reducing maternal mortality from preeclampsia and eclampsia in low‐resource countries – what should work?

Cited by 48 publications

References 22 publications

Pregnancy outcomes in younger and older adolescent mothers with severe preeclampsia

Pregnancy outcomes in younger and older adolescent mothers with severe preeclampsia

Fuzzy Intelligent System for Patients with Preeclampsia in Wearable Devices

Assessing multidimensional care coverage for pre‐eclampsia in the era of universal health coverage: A pre–post evaluation of the Salud Mesoamérica Initiative

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