Abstract:
Background: Hypertensive Disorders in Pregnancy continues to be among the top three
cause of maternal morbidity and mortality. More than 330,000 women die annually during
pregnancy and childbirth. Almost all of these deaths occur in low and middle-income
countries (99%). Reducing maternal mortality crucially depends upon ensuring that women
have access to quality care before, during, and after childbirth. Pre-eclampsia (PE)
accounts for 50,000 deaths annually globally. There is a need to assess the implementation
of WHO recommendations for the diagnosis and prevention of Preeclampsia/eclampsia to
reduce/prevent morbidity and mortality to mothers and children.
Objective: To assess the implementation of WHO recommendations for the diagnosis and
prevention of Preeclampsia/eclampsia offered to pre-eclampsia women attending the
antenatal care at Amana Referral Hospital.
Methods: It was a hospital-based cross-sectional study that assessed the implementation of
WHO recommendations for the diagnosis and prevention of Preeclampsia/eclampsia
offered to pre-eclampsia women at ANC-Amana Referral Hospital, who made at least four
visits. Clients were recruited consecutively as they attended and met the inclusion criteria.
Information was extracted from the antenatal card to assess the content of care received
including antenatal visits, blood pressure measurements, urine for protein, biochemical test,
number of and whether an obstetrical ultrasound was done. Assessment of counseling of
women on danger signs and other relevant information was obtained using a checklist after the clients have been reviewed by the clinicians. Data analysis was done using SPSS
version 23 and demographic data and other indicators were analyzed using frequency
tables.
Results: Of the two hundred and forty participants only (17.6%) received the
recommended ANC standard of care for Preeclampsia/Eclampsia. Four indicators on the
adapted WHO recommendations for the prevention of Preeclampsia/eclampsia were as
follows; blood pressure (22.9%), urine for protein (20.8%), obstetrical ultrasound (20%),
and biochemical parameters (17.8%). Also among participants only (38.3%) were
counseled on danger signs of pre-eclampsia during their ANC visits and only (18.3%) were
able to mention three danger signs, and (11.7%) were not able to mention any danger signs
despite being counseled.Conclusion: There is substandard care to the pre-eclampsia patient attending at Amana
ANC clinic. More effort should be put forward to ensure all pregnant mothers should
receive the standard and quality care during ANC visits. Also to improve the best practice
in counseling of danger signs to all mothers to reduce/prevent maternal-fetal
morbidity/mortality and have a better pregnancy experience and good outcome
