Preeclampsia in Low and Middle Income Countries—Health Services Lessons Learned From the PRE-EMPT (PRE-Eclampsia–Eclampsia Monitoring, Prevention & Treatment) Project

• Published in: Journal of obstetrics and gynaecology Canada Vol. 34; no. 10; pp. 917 - 926
• Main Authors: von Dadelszen, Peter, MBChB, DPhil, Firoz, Tabassum, MD, Donnay, France, MD, MPH, FACOG, FRCOG, Gordon, Rebecca, BSc, Justus Hofmeyr, G., FRCOG, Lalani, Shifana, MSc, Payne, Beth A., BSc, Roberts, James M., MD, Teela, Katherine C., MHS, Vidler, Marianne, MPH, Sawchuck, Diane, RN, PhD, Magee, Laura A., MD, MSc
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.10.2012
• Subjects: area under the receiver-operator characteristic curve; AUC ROC; blood pressure; Calcium - administration & dosage; Calcium - adverse effects; Developing Countries; Eclampsia - epidemiology; Eclampsia - prevention & control; Eclampsia - therapy; EPIC; European Prospective Investigation into Cancer and Nutrition study; Female; global health; hazard ratio; Humans; hypertensive disorders of pregnancy; Income; LMIC; low and middle income countries; Maternal Health Services; MDG; Millennium Development Goal; Obstetrics and Gynecology; PIERS; Pre-Eclampsia - epidemiology; Pre-Eclampsia - prevention & control; Pre-Eclampsia - therapy; Pre-eclampsia Integrated Estimate of RiSk; Pre-eclampsia–Eclampsia Monitoring, Prevention & Treatment; PRE-EMPT; Preeclampsia; Pregnancy; Proteinuria - therapy; RDA; recommended daily allowance; relative risk; global health; PRE-EMPT; RR; blood pressure; PIERS; EPIC; low and middle income countries; hypertensive disorders of pregnancy; HR; area under the receiver-operator characteristic curve; BP; RDA; relative risk; MDG; European Prospective Investigation into Cancer and Nutrition study; recommended daily allowance; AUC ROC; Pre-eclampsia Integrated Estimate of RiSk; Pre-eclampsia–Eclampsia Monitoring, Prevention & Treatment; Preeclampsia; hazard ratio; LMIC; Millennium Development Goal
• ISSN: 1701-2163
• DOI: 10.1016/S1701-2163(16)35405-6

Abstract The hypertensive disorders of pregnancy, in particular preeclampsia, matter because adverse events occur in women with preeclampsia and, to a lesser extent, in women with the other hypertensive disorders. These adverse events are maternal, perinatal, and neonatal and can alter the life trajectory of each individual, should that life not be ended by complications. In this review we discuss a number of priorities and dilemmas that we perceive to be facing health services in low and middle income countries as they try to prioritize interventions to reduce the health burden related to preeclampsia. These priorities and dilemmas relate to calcium for preeclampsia prevention, risk stratification, antihypertensive and magnesium sulphate therapy, and mobile health. Significant progress has been and is being made to reduce the impact of preeclampsia in low and middle income countries, but it remains a priority focus as we attempt to achieve Millennium Development Goal 5.