Assessment on implementation of WHO recommendations for the diagnosis and prevention of preeclampsia/eclampsia offered to the pre-eclampsia women attending antenatal care at the Amana referral hospital

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