Improving maternal and perinatal outcomes in the hypertensive disorders of pregnancy: A vision of a community-focused approach

Peter von Dadelszen; J Mark Ansermino; Guy Dumont; G Justus Hofmeyr; Laura A Magee; Matthews Mathai; Diane Sawchuck; Kate Teela; France Donnay; James M Roberts; PRE-EMPT (PRE-eclampsia-Eclampsia Monitoring, Prevention and Treatment) Group

doi:10.1016/j.ijgo.2012.03.012

Improving maternal and perinatal outcomes in the hypertensive disorders of pregnancy: A vision of a community-focused approach

Int J Gynaecol Obstet. 2012 Oct:119 Suppl 1:S30-S34. doi: 10.1016/j.ijgo.2012.03.012.

Affiliations

¹ Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
² Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada.
³ Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, Canada.
⁴ Department of Obstetrics and Gynaecology, University of Fort Hare, East London, South Africa.
⁵ Department of Medicine, University of British Columbia, Vancouver, Canada.
⁶ Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland.
⁷ Family Health Division, Global Health Program, The Bill & Melinda Gates Foundation, Seattle, USA.
⁸ Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, USA.

PMID: 29644651
DOI: 10.1016/j.ijgo.2012.03.012

Abstract

The hypertensive disorders of pregnancy (HDP; pre-existing hypertension, gestational hypertension, and pre-eclampsia) remain important causes of maternal morbidity and mortality, especially in low- and middle-income countries. The paper summarizes the current state of evidence around possible technologies to support community-based improvements in maternal and perinatal outcomes for women with pre-eclampsia. Through the testing and, where proven, introduction of these technologies, we believe that HDP-related progress toward achieving Millennium Development Goal 5 can best be accelerated. The evidence and discussion are presented under the following headings: (1) prediction; (2) prevention; (3) diagnosis; (4) risk stratification; (5) decision aids; (6) treatment; (7) geographic information systems; (8) communication; and (9) community and patient education.

Keywords: Community interventions; Eclampsia; Hypertensive disorders of pregnancy; Maternal outcome; Perinatal outcome; Pre-eclampsia.