Prevention and management of severe pre-eclampsia/eclampsia in Afghanistan

Y.M. Kim, N. Ansari, A. Kols, H. Tappis, S. Currie, P. Zainullah, P. Bailey, J. van Roosmalen, J. Stekelenburg

    Research output: Contribution to JournalArticleAcademicpeer-review

    Abstract

    Background: An evidence-based strategy exists to reduce maternal morbidity and mortality associated with severe pre-eclampsia/eclampsia (PE/E), but it may be difficult to implement in low-resource settings. This study examines whether facilities that provide emergency obstetric and newborn care (EmONC) in Afghanistan have the capacity to manage severe PE/E cases.Methods: A further analysis was conducted of the 2009-10 Afghanistan EmONC Needs Assessment. Assessors observed equipment and supplies available, and services provided at 78 of the 127 facilities offering comprehensive EmONC services and interviewed 224 providers. The providers also completed a written case scenario on severe PE/E. Descriptive statistics were used to summarize facility and provider characteristics. Student t-test, one-way ANOVA, and chi-square tests were performed to determine whether there were significant differences between facility types, doctors and midwives, and trained and untrained providers.Results: The median number of severe PE/E cases in the past year was just 5 (range 0-42) at comprehensive health centers (CHCs) and district hospitals, compared with 44 (range 0-130) at provincial hospitals and 108 (range 32-540) at regional and specialized hospitals (p < 0.001). Most facilities had the drugs and supplies needed to treat severe PE/E, including the preferred anticonvulsant, magnesium sulfate (MgSO
    Original languageEnglish
    Article number186
    JournalBMC Pregnancy and Childbirth
    Volume13
    DOIs
    Publication statusPublished - 2013

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