Hypertensive disorders of pregnancy (HDPs)—which are major contributors of maternal and newborn mortality, morbidity, and disability—are preventable. About 24 percent of maternal deaths in Bangladesh each year are due to pre-eclampsia and eclampsia (PE/E). A known cause of death in women with PE/E is cerebrovascular accident, which occurs due to rapidly increasing blood pressure (BP). Elevated BP associated with pregnancy should be detected and appropriately managed before onset of convulsions (eclampsia) and other life-threatening complications. For women presenting with severe PE/E, magnesium sulphate (MgSO4) is the recommended drug for convulsion management. Anti-hypertensive medicines are also recommended for control of high BP, but the authorization to prescribe these drugs, both for preventing and managing PE/E, is limited within lower-level primary health-care (PHC) facilities in Bangladesh. This report details implementation research findings assessing the feasibility of PHC providers identifying HDP and prescribing alpha methyldopa prior to referring patients to a higher-level facility for MgSO4 administration, if needed. The study was part of the Ending Eclampsia project to scale up a PHC model for early detection, prevention, and management of PE/E.
Hossain, Sharif M.I., Kanij Sultana, Shongkour Roy, Pooja Sripad, and Charlotte E. Warren. 2019. "Assessing the feasibility of primary health care provider prescription of anti-hypertensive medication to pregnant women in Bangladesh," Ending Eclampsia Anti-hypertensive Study Report. Washington, DC: Population Council.
Demography, Population, and Ecology Commons, Family, Life Course, and Society Commons, Gender and Sexuality Commons, International Public Health Commons, Maternal and Child Health Commons, Medicine and Health Commons, Women's Health Commons