Preventing deaths due to the hypertensive disorders of pregnancy

• Published in: Best practice & research. Clinical obstetrics & gynaecology Vol. 36; pp. 83 - 102
• Main Authors: von Dadelszen, Peter, MBChB, DPhil, FRCOG, Magee, Laura A., MD, MSc, FRCPC
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.10.2016; Elsevier
• Subjects: Aspirin - therapeutic use; Birth Intervals; Calcium - therapeutic use; Cardiotocography; Dietary Supplements; Eclampsia - diagnosis; Eclampsia - prevention & control; Eclampsia - therapy; Female; Food Supply; Health Facilities; Humans; Hypertension - complications; Hypertension - diagnosis; Hypertension - therapy; Hypertension, Pregnancy-Induced - diagnosis; Hypertension, Pregnancy-Induced - prevention & control; Hypertension, Pregnancy-Induced - therapy; Infant, Newborn; Mass Screening; Maternal Death - etiology; Maternal Death - prevention & control; maternal mortality; medical interventions; Obesity; Obstetrics and Gynecology; Patient Participation; Perinatal Death - etiology; Perinatal Death - prevention & control; Platelet Aggregation Inhibitors - therapeutic use; Pre-Eclampsia - diagnosis; Pre-Eclampsia - prevention & control; Pre-Eclampsia - therapy; Preconception Care; Pregnancy; Pregnancy Complications, Cardiovascular - diagnosis; Pregnancy Complications, Cardiovascular - therapy; pregnancy hypertension; Prenatal Care; Proteinuria - diagnosis; Reproductive Behavior; societal interventions; Stillbirth; pregnancy hypertension; medical interventions; societal interventions; maternal mortality
• ISSN: 1521-6934; 1532-1932
• DOI: 10.1016/j.bpobgyn.2016.05.005

In this chapter, taking a life cycle and both civil society and medically oriented approach, we will discuss the contribution of the hypertensive disorders of pregnancy (HDPs) to maternal, perinatal and newborn mortality and morbidity. Here we review various interventions and approaches to preventing deaths due to HDPs and discuss effectiveness, resource needs and long-term sustainability of the different approaches. Societal approaches, addressing sustainable development goals (SDGs) 2.2 (malnutrition), 3.7 (access to sexual and reproductive care), 3.8 (universal health coverage) and 3c (health workforce strengthening), are required to achieve SDGs 3.1 (maternal survival), 3.2 (perinatal survival) and 3.4 (reduced impact of non-communicable diseases (NCDs)). Medical solutions require greater clarity around the classification of the HDPs, increased frequency of effective antenatal visits, mandatory responses to the HDPs when encountered, prompt provision of life-saving interventions and sustained surveillance for NCD risk for women with a history of the HDPs.