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Resource Type: Report

Retrospective Cohort Study: Clinical Presentation and Outcomes of Pre-eclampsia and Eclampsia at Kenyatta National Hospital Nairobi, Kenya

It is increasingly recognized that pre-eclampsia has two distinct sub-types, depending on the timing of onset: early onset pre-eclampsia, which occurs before 34 weeks of gestation, and late onset preeclampsia, which occurs after 34 weeks. Few studies, however, examine and compare early and late onset pre-eclampsia in a low- and middle-income country setting.

This study’s goal was to establish a profile of patients with hypertensive disorders in pregnancy, especially pre-eclampsia and eclampsia, over a two year period. At Kenya’s national referral hospital, we examined clinical presentation at admission, management of complications, along with maternal and newborn health outcomes in the hospital’s busy maternity unit, to ascertain any differences in health outcomes for early and late onset pre-eclampsia.

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Resource Type: Report

Addressing Barriers to Quality of Underutilized Commodities and Services for Prevention and Management of Pre-eclampsia and Eclampsia in Kenya

This qualitative study explored health system bottlenecks that prevent access to quality maternal and newborn health (MNH) care in two Kenyan counties, Kitui and Kakamega, with a specific focus on PE/E.

This study explored policy implementation gaps in Kenya’s newly-devolved county government structure, to: 1) assess the policy and health system environment for PE/E diagnosis, referral, and treatment, including potential supply chain bottlenecks, 2) investigate similarities and differences in PE/E knowledge, attitudes, and care-seeking behaviors among providers, women and community members, and 3) generate lessons for scaling up proven under-utilized PE/E interventions more effectively.

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Resource Type: Report

Feasibility and Acceptability of Community Health Extension Workers to Identify and Treat Hypertension Associated with Pregnancy: Implementation Research Report

Nigeria’s task shifting policy recommends that community health extension workers administer a loading dose of magnesium sulphate prior to referral for severe preeclampsia or eclampsia to a higher level facility. The success achieved with magnesium sulphate task shifting to lower level health facilities has not been widely explored with anti-hypertensive drugs to control high blood pressure in pregnant women.

This study tested the feasibility and acceptability of community health extension workers at primary healthcare facilities in Ebonyi state to detect and manage pregnancy-associated hypertension using alpha methyldopa and magnesium sulphate where appropriate and refer for follow up. Baseline data were
collected from 10 of 13 local government areas in 40 primary healthcare centers (20 interventions and 20 comparison) in 2016 and endline in November 2017.

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Resource Type: Report

Exploring barriers and opportunities for pre-eclampsia and eclampsia prevention and management in Ethiopia

In Ethiopia an estimated 19 percent of maternal deaths result from hypertensive disorders of pregnancy (HDP). Globally, HDP—which include pre-eclampsia and eclampsia (PE/E)—are the second most common cause of maternal mortality and an underlying cause of preterm birth, stillbirth and neonatal death.

This study was guided by an institutional ethnographic approach, engaging different points of view and data sources. Ending Eclampsia project researchers qualitatively investigated perspectives throughout the health system with qualitative data from Ethiopia’s Southern Nations, Nationalities, and Peoples Region (SNNPR), by conducting in-depth interviews (IDIs) with 21 policymakers and stakeholders—at national, regional, zonal, and woreda (district) levels—as well as with 41 health workers at health posts, health centers, and hospitals.

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Resource Type: Journal Article

Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial

Regimens for the acute treatment of severe hypertension typically include intravenous medications. Although effective, these drugs require venous access and careful fetal monitoring and might not be feasible in busy or low-resource environments.

This study aimed to compare the efficacy and safety of three oral drugs, labetalol, nifedipine retard, and methyldopa for the management of severe hypertension in pregnancy.

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Resource Type: Journal Article

Screening and management of preeclampsia and eclampsia in antenatal and labor and delivery services: findings from cross-sectional observation studies in six sub-Saharan African countries

This study highlighted notable deficiencies in six countries in relation to pre-eclampsia and eclampsia (PE/E) screening and treatment, which are echoed in findings from the literature. Findings from these studies suggest the majority of women attending antenatal care and labor and delivery services are not screened according to WHO-recommended standards.

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Resource Type: Brief

Antihypertensive drugs for high blood pressure in pregnancy

Despite being safe, low-cost, effective, and commonly
available, antihypertensive drugs may not be available to women and families who need them. However, members
of Maternal Health Caucus of the Reproductive Health Supplies
Coalition agree antihypertensive drugs should be part of the
essential medicines list for maternal health.

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Resource Type: Journal Article Resource Type: Journal Article Resource Type: Journal Article

Prophylactic magnesium sulphate in prevention of eclampsia in women with severe preeclampsia: randomised controlled trial (PIPES trial)

Optimum dose, route and duration of use of prophylactic magnesium sulphate in women with severe pre-eclampsia are still unclear. This study compared the efficacy and safety of 'low-dose Dhaka' regime with 'Loading dose only' regime for seizure prophylaxis in severe pre-eclampsia using a randomised controlled trial in 402 women in Bangladesh.

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