Hypertensive disorders of pregnancy: An assessment of prevalence and care of preeclampsia-eclampsia patients at Queen Elizabeth Central Hospital (QECH)

Rashid, Bakali; Davis, Caroline; Chasi, Panache; Casten, Chikumbutso

Hypertensive disorders of pregnancy: An assessment of prevalence and care of preeclampsia-eclampsia patients at Queen Elizabeth Central Hospital (QECH)

Date

2022-07-25

Authors

Publisher

Kamuzu University of Health Sciences

Abstract

Type of study: The study will be a retrospective cross-sectional study, comprising of both qualitative and quantitative data. 1.2 Research Problem There is a growing burden of Non-Communicable Diseases (NCDs) including hypertensive disorders of pregnancy. Despite current strides in medicine, hypertensive disorders of pregnancy still cause substantial morbidity and mortality. There is also paucity of local data on prevalence and risk factors for hypertensive disorders of pregnancy. This study will therefore seek to fill the informational gap on prevalence of preeclampsiaeclampsia, and common risk factors, and will seek to understand current disparities in the healthcare system by investigating the facilitators and barriers to care of preeclampsia-eclampsia at Queen Elizabeth Central Hospital. 1.3 Objectives Broad Objective: To assess the prevalence, risk factors and management of gestational hypertension amongst pregnant women attending Queen Elizabeth Central Hospital (QECH), Blantyre. Specific Objectives: 1) To explore the prevalence of preeclampsia and eclampsia amongst pregnant women attending QECH between July and December 2021 2) To investigate the age group most affected by preeclampsia and eclampsia 3) To describe sociodemographic and maternal factors associated with preeclampsia and eclampsia 4) To describe management practices for preeclampsia and eclampsia at QECH maternity unit. 1.4 Methodology The study will include pregnant women admitted and treated at QECH between July and December 2021 diagnosed with a diagnosis of hypertensive disorder of pregnancy. Through objectives 1 and 2: 25-Jul-2022 In patient registers at Antenatal Care (ANC), Labor Ward (LW) and Post Natal Care (PNC) for the period will be reviewed to identify women diagnosed with hypertension and based on the list case notes of the women will be extracted from medical records office as well as those critically ill having either survived or passed. Data on socio demographic profile of the patients such as age, residence and underlining conditions will be extracted from said files. Additionally, data on disease diagnosis, treatment and outcome will also be extracted from the same registers. For objective 3, we will interview clinicians and nurses at the facility on their management as compared to the standard treatment guidelines of preeclampsia and eclampsia. Sampling strategy will be purposive sampling and the sample size will be 40. Data will be collected using questionnaires and interviews. Inclusion criteria will be all patients above 18 years of age diagnosed with preeclampsia and eclampsia. 1.5 Expected Findings • We expect to have a higher prevalence of preeclampsia and eclampsia at QECH compared to any other hypertensive disorders of pregnancy. • We expect that most women will have little knowledge on symptoms and care of preeclampsia and eclampsia • We expect that QECH treats preeclampsia and eclampsia according to the standard treatment guidelines set by the WHO. • We expect that misdiagnosis plays a key role in the mismanagement of the condition 1.6 Dissemination Study results will be presented at the research dissemination conference at KUHES in Blantyre, Malawi. A report submitted to the College of Medicine Research and Ethics Committee (COMREC), College of Medicine Library, the Health Sciences Research Committee (through the COMREC Secretariat), the University Research and Publication Committee (URPC) (through the COMEC Secretariat) as well as the QECH Paediatrics department.