Challenges associated with hypertensive disease during pregnancy in low-income countries

Abstract

Objective To assess the challenges associated with the diagnosis, management, and prevention of hypertensive disease during pregnancy in low-income countries, following the success of the Magpie Trial. Methods Descriptive review of the literature from 1990 to 2009 on the diagnosis, management, and prevention of hypertensive disease in pregnancy. Results In the absence of credible measures to predict and prevent hypertension in pregnancy, diagnosis and treatment remain the only viable options, although they are still associated with important challenges in low-income countries. Despite the presence of high-quality evidence that magnesium sulfate is safe and effective at preventing and treating eclampsia, its use is extremely limited in many low-income countries. Conclusion There is a need for cheap and reliable tools with which to address the diagnostic, preventive, and management challenges associated with hypertensive disease during pregnancy in low-income countries. It is recommended that such countries incorporate magnesium sulfate protocols into their national health and/or practice policies.