Local Midwives Research Articles

Penilaian Status Gizi, Edukasi dan Pengenalan Inovasi Pangan sebagai Upaya Pencegahan Stunting pada Ibu Hamil di Desa Rejosari Kabupaten Demak

<p><em>Stunting is malnutrition that occurs gradually and is prolonged. In general, according to Riskesdas (2018), the prevalence of stunting in Indonesia is 30.8%, and in Demak 26.1%. Meanwhile in Rejosari Village. Based on data from local midwives, there are 15 stunted children in Karangawen, Demak. The purpose of dedication is as a preventive measure so that the incidence of stunting under five in Rejosari Village, Demak Regency does not increase. The implementation began with a health stand, and interactive discussions, and ended with a cooking demonstration for pregnant women. The activity began with an anthropometry stand, continued with education on the importance of the role of 1000 HPK, questions, and answers, and ended with a demonstration on making Moringa Chicken Tofu Balls. The results of the "Si Penting" program show that there are still pregnant women who have the potential to give birth to LBW children, as evidenced by a BMI before pregnancy of less than 18 kg/m2 and a LILA of less than 23.5 cm. Apart from that, food education and innovation activities ran smoothly, participants asked many questions and had lively discussions.</em></p>

The Competence and Authority of Midwives in giving Birth without the assistance of a Doctor in Nigeria

Life per se is not short, but our actions and inaction often result in the shortness of our life. This quote is concerning the fact that in Nigeria and the global standard it is required that during childbirth delivery there should always be a doctor present to avoid complications that may result in the death of the mother or the child. However, in Nigeria, it has been observed that the majority of the childbirth delivery conducted in hospitals or at any other place by local or trained mid-wife are often executed without the involvement or presence of a doctor. In this regard, is it legally and medically in abeyance to conduct childbirth delivery without the aid of a doctor, given the possible complication that may result in loss of life and damage to the mother and child. It is in this regard that this study tends to adopt a hybrid method of study (involving a doctrinal and non-doctrinal) in ascertaining the legal issues and challenges in curtailing mid-wife involvement in child delivery in the absence of a medical doctor. 307 questionnaires were distributed to respondents, and the data obtained were analyzed by adopting an analytical and descriptive method. The study, therefore, found that there are very high incidences of the mortality rate of a pregnant mother and their baby during delivery by mid-wife and nurses given the absence of a doctor. The study further found that though there are laws and ethical codes that regulate childbirth delivery in Nigeria, however, there are challenges that often mitigate the curtailment of mid-wife or nurses involved in childbirth delivery without the aid of a doctor. We thus concluded and recommended that authorities should establish effective regulations and sanctions for midwives or nurses participating in childbirth deliveries without the presence of a doctor.

Edukasi Persiapan Diri Ibu dalam Menghadapi Persalinan untuk Menurunkan Tingkat Kecemasan dan Persiapan Mental Ibu di Poskeskel Batu Hampa

Childbirth is a process that must be prepared for because it plays a major role in how first-time mothers will develop good self-esteem, positive feelings for the baby and an easier adjustment to the role of mother. Fear and unpreparedness in facing childbirth will have a negative impact both during the birth process which will have an impact on the health of the mother and fetus as well as in the lactation process and optimizing mother and baby bonding. The aim of this community service activity is to provide education on the mother's self-preparation for childbirth including the importance of preparing for childbirth, the mother's self-preparation for childbirth, self-empowerment that pregnant women can do in preparing themselves for the birth process, the importance of positioning during pregnancy to optimize the position of the fetus. and presentation and re-demonstration of pregnancy exercises. Activities were carried out at the Poskeskel Batu Hampa involving local village midwives and health cadres. This activity was very positively welcomed by the village midwives and participants as evidenced by the enthusiasm of the participants in participating in the activity. Hopefully this activity can become a routine agenda so that it becomes a provision for pregnant women when facing childbirth.

Evaluation of Antimicrobial Activities of Medicinal Plants Used against Microbial Infections in Pregnant Women in Delta State, Nigeria

Pregnant women are important people in society. As such, their health condition is paramount. Healthy babies reflect the health condition of fetus in the womb and the mother. In Nigeria, pregnant women consult local midwives for the purpose of their health and that of their unborn children. Medicinal plant ingestion is common among pregnant women as they believe it is safe and effective for curing ailment and maintaining good health. Microbial diseases that infect pregnant women are numerous. There is therefore a need to detect other bioactive compounds which could be used for treating and maintaining good health in pregnant women. The study was designed to evaluate the antimicrobial activities of medicinal plants used for pregnancy care. Medicinal plants used were identified by oral interview. Microorganisms were isolated and identified by standard methods from urine samples. Result from oral interviewers showed that some medicinal plants and substances including kaolin clay were used by pregnant women. Microrganisms identified were Pseudomonas aeruginosa, Staphylococcus aureus, and others including Candida albicans. Ficus exasperata and Solenostemon monostachyus were active against Candida albicans at 12.5mg/ml but not active on any bacteria. Peperomia pellucida had no inhibitory effect on any of the microorganism. In conclusion, Ficus exasperata and Solenostemon monostachyus could be used to treat microbial infections caused by Candida ablicans during pregnancy.

Health professionals’ knowledge about female genital schistosomiasis. A qualitative investigation in a schistosomiasis endemic area in South Africa

Female Genital Schistosomiasis (FGS) is a neglected tropical disease that affects the lives of millions of women living in endemic areas. The aim of this study was to identify South African healthcare professionals' perceptions and experiences of Female Genital schistosomiasis. This qualitative study took place in Ugu District, KwaZulu-Natal, South Africa, in one Community Health Centre and two Primary Health Care clinics. The purpose was to explore local healthcare professionals' views and knowledge on FGS in an area endemic for Schistosoma haematobium, referred to as bilharzia, or isichenene in isiZulu. The empirical findings collected through interviews and observations are discussed in relation to the well-established research on FGS. This project also took cognizance of the United Nations (UN) sustainability development goals (SDGs) with a focus on gender and sanitation, as well as control programmes to prevent schistosomiasis. The study showed that there was a multi-faceted gap in knowledge between local midwives and professional nurses’ work-related knowledge and the medical research team. Among the main causes are skewed power relations, whereby the women affected by FGS often have low socioeconomic status in society while the higher power structures do not prioritize FGS. This leads to health professionals being in a “middle position” where they are responsible for community health but are governed by their training and the guidelines of the institution in which they are a part. Furthermore, the study showed the importance of culture since nurses and midwives consult with patients, as they are part of a framework where their role is constrained due to governmental policies, protocols for patient care and the local culture. To provide adequate health services for FGS patients, this study indicates that policy, female patient management protocols, curricula, post graduate training, clinical practice and schistosomiasis prevention programs should include FGS.

Midwifery Workforce Density Moderates the Association Between Independent Practice and Pregnancy Outcomes.

Studies comparing pregnancy outcomes before and after state transition to independent midwifery practice have found little change in primary cesarean birth and preterm birth rates. One reason may be the failure to control for midwife density. The objective was to test if the local midwife density moderates the association between state independent midwifery practice and pregnancy outcomes. Birth records were abstracted from the State Inpatient Databases for 6 states. The Area Health Resource File provided county variables. Midwife density was operationalized as no midwives, low midwife density (<4.5 per 1000 births), and high midwife density (≥4.5 midwives per 1000 births). Multivariate logistic regression models compared primary cesarean birth and preterm birth, controlling for maternal and county characteristics. Moderation was tested by including an interaction term (independent practice × density) to the regression models. The magnitude of association for the interaction was measured by stratifying the models. The study included 875,156 women; most (79.7%) resided in a county with low midwife density. Restricted midwifery practice was associated with increased odds of both primary cesarean birth and preterm birth. The interaction term was significant for both preterm birth and primary cesarean, indicating moderation. The largest magnitude of difference was the increased odds of preterm birth in counties with a high midwife density and restricted practice (odds ratio, 3.50; 95% CI, 2.43-5.06) compared with those with high midwife density and independent practice. Midwife density moderates the association between independent midwifery practice and primary cesarean birth and preterm birth. Moderation may explain why prior studies found small or no changes in outcomes when states adopted independent practice. Moderation models can improve testing for associations with independent practice. Both midwife independent practice and increasing midwifery workforce size can be strategies to improve state pregnancy outcomes.

Creating an Alianza: Group Perinatal Education for Newly Immigrated Latinx Pregnant People.

Pregnant people who are recent immigrants often face barriers navigating the health care system and establishing a support network to sustain them through pregnancy and new parenthood. The Cultivando una Nueva Alianza (CUNA) program from the Children's Home Society of New Jersey was created to address these obstacles. For over 20 years, CUNA has collaborated with local midwives to develop a program for newly immigrated, Spanish-speaking Latinx pregnant people. The curriculum, facilitated by trained members of the community, provides education around pregnancy, birth, and early parenting and connects participants with prenatal care and community resources while cultivating a social support network. The program's success is seen in improved clinical outcomes, ongoing involvement by graduates, and strong continued support from community stakeholders. The CUNA program has been replicated in nearby communities and offers a blueprint for a low-tech intervention to improve the health and wellness of this population.

Assistance for Pregnant Women and Families in Early Detection of Preeclampsia (PE) and Early Referral Planning as an Effort to Prevent Complications

The purpose the activity is to increase the participation of pregnant women and families in early detection of Preeclampsia (PE) risk and early referral planning as an effort to prevent complications. The methods are carried out in several stages, namely pregnancy health education with PE, early detection screening by health workers using the 2020 MCH book guidelines (risk factor history, as well as BMI, Mean Arterial Pressure and urine protein checks. If the screening results found the risk of PE or diagnosed PE (BP ≥ 140/90 mmHg and positive urine protein) then followed by reporting to the local midwife, motivating the mother for early referral action planning and assistance during pregnancy. Results: knowledge of pregnant women and families about PE increased from 67% in the poor category, after receiving information 92% in the good category. Early detection screening by health workers using the 2020 MCH book guidelines, out of 12 pregnant women, 2 people (16.7%) had a risk of PE and 10 people (83.3%) did not have a risk of PE. None of the pregnant women were diagnosed with PE. 2 pregnant women who have the risk of PE (100%) have been reported to the Kapor village midwife and are willing to be referred to the Burneh Puskesmas. There is an increase in community participation (pregnant women and families) in early detection of PE and early referral planning as an effort to prevent complications.&#x0D;

Volunteering in an emergency project in response to the COVID-19 pandemic crisis: the experience of Italian midwives

ObjectivesDuring the first wave of the COVID-19 pandemic, the Region of Lombardy in Italy and its Regional Emergency Service (Azienda Regionale Emergenza Urgenza [AREU]) created a dedicated 24/7 free phone service to help the Lombard population. After an invitation from their professional order, local midwives collaborated on the AREU project as volunteers to address the needs of women from antenatal to postnatal periods. The aim of this article was to explore the experiences of midwives who volunteered in the AREU project. Study designThis was a qualitative study using an interpretative phenomenological approach (IPA). MethodsThe experiences of midwives volunteering in AREU (N = 59) were explored using audio diaries. Written diaries were also offered as an alternative. Data collection took place between March and April 2020. Midwives were provided with semistructured guidance that indicated the main areas of interest of the study. The diaries were thematically analysed following a temporal criterion; a final conceptual framework was created from emerging themes and subthemes. ResultsThe following five themes were identified: (1) choosing to join the volunteer project, (2) the day-to-day difficulties, (3) strategies to cope with the unexpected, (4) professional relationships and (5) reflecting on the personal experience. ConclusionsThis is the first study to investigate the experiences of Italian midwives who volunteered in a public health project during a pandemic/epidemic. According to participants, taking part in the volunteer activities was informed by and impacted on both their professional and personal lives. Overall, the experiences of midwives who volunteered in AREU were positive and of humanitarian value. Providing midwifery services within a multidisciplinary team for the benefit of public health represented both a challenge and personal/professional enrichment.

PEMANFAATAN ALAT TERMOMETER OTOMATIS DALAM MENINGKATKAN PELAYANAN DI POSYANDU DESA PULOGEDANG

By looking at the current development of technology, it is necessary to carry out reforms in various scientific fields ranging from economics, education to the health sector. But what is happening in society, the latest technology is not really sufficient either in terms of manufacture or utilization. The objectives of the community service program that is being carried out include: 1) the community is well acquainted with the results of the latest technology. 2) people are able to understand more deeply related to today's technology. To achieve this goal, several activities were carried out, such as: 1) Participating in supporting activities related to health program partners, namely posyandu officers, cadres and local midwives, 2) Conducting seminars. The results of this activity are in the form of understanding and utilization in the form of a thermometer tool. The tool was measured using a questionnaire and yielded a value of 90%, so it can be concluded that in the program of activities this community group is interested in developing an automatic thermometer tool.&#x0D; &#x0D;

Perancangan dan implementasi e-posyandu untuk peningkatan pelayanan kader di posyandu delima berbasis web

The problem found was ineffective service because the information was not appropriately conveyed to the parents of toddlers because the cadres did the recording and counting manually. Age calculations were carried out every month by cadres using a specific formula. In addition, determining nutritional status was also done manually by matching the examination data with the Z-score table according to the sex, weight, and height of each toddler. Due to limited human resources, this was often not done, so the nutritional status of toddlers was not filled, and parents did not know for sure the nutritional status of their toddlers. Solution provided by implementing an information system referred to as e-posyandu. E-posyandu can display a recapitulation of toddler examinations in real-time, which can be monitored directly by the responsible local health center midwife. The implementation method in this study is divided into several stages: problem identification, system design, information system development, and implementation. The results obtained are that e-posyandu can assist Posyandu Delima cadres in recording development and growth digitally, thus facilitating and improving the quality of cadre services in carrying out posyandu checks can also help parents to monitor the results of the toddlers' development and growth

Peningkatan Keterampilan Deteksi Dini Dan Manajemen Awal Kegawatdaruratan Ibu Hamil

Background: The mortality rate in Indonesia, particularly in Bantul, remains quite high. Recognizing signs and symptoms of emergency cases in pregnant women and their families and midwives' preparedness as the community's spearhead of health services is essential in dealing with emergency cases of pregnant women. Methods: The lecture method, question and answer, and practical skills for midwives are used. The achievement of the activity is evaluated by analyzing the knowledge of pregnant women and midwives both before and after the activity. The T-test was used to analyze the data. Results: The results obtained are quite satisfactory. It was demonstrated by the high level of interest displayed by the participants during the question and answer session. Quantitative results from statistical tests revealed a significant increase in knowledge in pregnant women (53.90 21.97 vs. 89.47 9.7; P 0.000) and local health centre midwives (72.60 7.04 vs. 79.46 7.21; P 0.001). Conclusion: There was an increase in pregnant women's knowledge of recognizing the signs and dangers of pregnancy and midwives' knowledge and skills in terms of early detection and emergency treatment of pregnant women at community health centres.

Psychoeducation as an effort to reduce stunting rates in Genikan Village

According to Nutrition Status Monitoring (PSG) data from Magelang Regency in 2018, 38.3% of children under the age of five were stunted. In comparison to 2017 (32.51%) and 2016 (14.30%), this figure has risen. The main goal of this program is to reduce stunting rates through parenting, nutrition, and early marriage programs. Counseling on nutrition, psychoeducation on healthy parenting, psychoeducation on the risks of early marriage and marriage preparation to build a healthy family, and play for children are among the programs offered. Village officials and local midwives are involved in the implementation of this program, which takes place in the Genikan Village’s multipurpose building. On the basis of the activities' implementation, it can be concluded that the community service activities in Genikan Village are proceeding as planned. Every program that has been prepared has a good chance of being implemented successfully and receiving positive feedback from the local community. In order to reduce stunting rates in Genikan Village, it is hoped that all of the programs that have been implemented will be useful and provide additional knowledge to the community.

Medical work and Nyasaland missionaries

Pauline Pretorius, born Murray, worked as a Dutch Reformed Church [DRC] mission doctor in Nyasaland (now Malawi) from 1928–1976, but little has been written about her life and extraordinary career. A disproportionate number of books and articles have been published by or about male DRC missionaries in Nyasaland, while women’s stories have been overlooked. This article discusses the significant contributions made by Dr Pauline Murray to improve healthcare practices for women and children in Nyasaland and her efforts to train local midwives in Mlanda, Nyasaland, from 1928–1941. This article argues that recovering female missionaries’ stories is important and suggests that Murray’s work in Nyasaland can be read as an example of a medical missionary who considered her work an “act of service to others”. Many descendants of Andrew Murray Sr worked as (medical) DRC missionaries in Nyasaland and, although this article focuses on the life and work of Pauline Murray, mention is made of the notable contributions made to the field of medicine by members of the extended Murray family.

The IMPLEMENTATION OF THERAPEUTIC GROUP THERAPY IN PREGNANT WOMEN IN EFFORTS TO ACHIEVE OPTIMUM CHILD DEVELOPMENT IN WORKING AREA OF PEKAN HERAN PUBLIC HEALTH CENTER, INDRAGIRI HULU DISTRICT

One of the factors that influence the case of stunting in children is the mother's parenting manner. This parenting manner is not only when the baby is born, but since the baby is still in the womb of the mother, which in turn can affect the child's growth and development. In an effort to prepare a physically, psychologically and socially healthy pregnancy and fetus both in the womb and in the future. a group of therapeutic therapy was administered to pregnant women. Although there have been efforts to improve maternal health through various government programs, these efforts have only touched on the physical aspects and have not yet addressed the efforts to improve the psychosocial and psychological aspects of pregnant women. This is important because cognitive and emotional growth and development of children are closely related to maternal psychological problems during pregnancy. Many studies have reported that the case of depression in pregnant and lactating women has resulted in delays in cognitive and emotional development of children at various ages, so this intervention is important. Therapeutic Group Therapy (TKT) in pregnant women is important in the hope that pregnant women can adapt well to any changes in pregnancy, especially psychological changes and are able to stimulate the development of the fetus they contain. This TKT can be followed by all 11 participants with a value of&gt; 2 meaning that participants can continue until all sessions at this TKT are finished, but they must always be monitored during its implementation and involve local midwives in this activity so that participants are able to independently care for babies and also able to carry out the role of the mother proportionally, after giving birth later.

Rural Australian Doctors’ Views About Midwifery and Midwifery Models of Care: A Qualitative Study

BACKGROUND AND PURPOSEAustralian rural areas access to midwifery continuity of carer models is restricted. Lack of medical support has been identified as one of the reasons midwifery continuity of carer models have not been implemented. The purpose of his study was to explore rural Australian doctors’ views about midwifery and midwifery continuity of carer models.STUDY DESIGNA qualitative study with general practitioner and specialist obstetricians (n = 10) working in Australian rural maternity services. Semi-structured interviews were undertaken and analyzed using thematic analysis.FINDINGSParticipants’ views of midwifery and midwifery continuity of carer models were expressed in three themes. The themes related to the concepts of knowing: knowing the model, knowing the midwife, and knowing the system. Participants had misconceptions and misunderstandings of the model, midwifery, and systems issues relating to midwifery continuity of carer models.CONCLUSIONIncreasing understanding about midwifery and midwifery continuity of carer models may facilitate implementation of these models. A national education program for doctors about the structure and function of midwifery continuity of carer models would support knowledge building for obstetric doctors. Strong leadership and incentivization for health services may be needed to sustainably roll-out rural models. At a service level, responsibility for establishing and sustaining models should shift from local midwife leaders to hospital executives.

Mothers Delivery Kit: Antenatal Care Innovation in West Africa

The Mothers Delivery Kit discusses an innovative healthcare package sold in the poor West African region to aid with the delivery of expectant mothers. The package combines various necessary items used for proper and hygienic delivery of the rural and remote mothers with the help of a local midwife or medical practitioner. Antenatal care in the region is poor due to lack of infrastructure and government funding in healthcare. The Mothers Delivery Kit addresses that issue by providing a cheap and hygienic alternative to conventional delivery methods. The kit has decreased newborn death in the region noticeably. The founders have worked closely with local midwives to train them and enable them to use the Mothers Delivery Kit properly to improve delivery conditions. Regardless of the setbacks caused by local traditional beliefs and culture, the kit has proven to be an active effort to improve delivery conditions.

Addressing social inequity through improving relational care: A social-ecological model based on the experiences of migrant women and midwives in South Wales.

Migrant and ethnic inequalities in maternal and perinatal mortality persist across high-income countries. Addressing social adversity and inequities across the childbirth trajectory cannot be left to chance and the good intentions of practitioners. Robust, evidence-based tools designed to address inequity by enhancing both the quality of provision and the experience of care are needed. An inductive modelling approach was used to develop a new evidence-based conceptual model of woman-midwife relationships, drawing on data from an ethnographic study of relationships between migrant Pakistani women and midwives, conducted between 2013 and 2016 in South Wales, UK. Key analytic themes from early data were translated into social-ecological concepts, and a model was developed to represent how these key themes interacted to influence the woman-midwife relationship. Three key concepts influencing the woman-midwife relationship were developed from the three major themes of the underpinning research: (1) Healthcare System; (2) Culture and Religion; and (3) Family Relationships. Two additional weaving concepts appeared to act as a link between these three key concepts: (1) Authoritative Knowledge and (2) Communication of Information. Social and political factors were also considered as contextual factors within the model. A visual representation of this model was developed and presented. The model presented in this paper, along with future work to further test and refine it in other contexts, has the potential to impact on inequalities by facilitating future discussion on cultural issues, encouraging collaborative learning and knowledge production and providing a framework for future global midwifery practice, education and research. At the outset of the underpinning research, a project involvement group was created to contribute to study design and conduct. This group consisted of the three authors, an Advocacy Officer at Race Equality First and an NHS Consultant Midwife. This group met regularly throughout the research process, and members were involved in discussions regarding ethical/cultural/social issues, recruitment methods, the creation of participant information materials, interpretation of data and the dissemination strategy. Ideas for the underpinning research were also discussed with members of the Pakistani community during community events and at meetings with staff from minority ethnic and migrant support charities (BAWSO, Race Equality First, The Mentor Ring). Local midwives contributed to study design through conversations during informal observations of antenatal appointments for asylum seekers and refugees.

Midwives and Dukun Beranak, the Choices for Handling Childbirth

Since the colonial era, there have been attempts to provide clinical childbirth services by establishing midwifery schools. Although these schools were closed, reorganized then re-opened several times, in an effort to graduate native midwives in the colony. The majority of the European doctors believed the existence of native midwives could reduce mortality rates for difficult deliveries. The colonial government also tried to replace dukun beranak (local midwives) with graduate midwives, as many doctors considered dukun beranak practices unsafe and unhygienic. Of note, even though midwifery school graduates provided childbirth services, most of the population preferred to use dukun beranak. This situation continued until independence. Dukun beranak remained the preferred provider of assistance among the working and lower class. The continued popularity of the dukun beranak can be seen as a colonial failure to replace them. After the proclamation of Indonesian independence, midwives who supported the Indonesian Republic, still provided childbearing assistance although with limited infrastructure and inadequate personnel during the independence war. Midwives also founded a midwifes association, rebuilt the national midwifery system, and discontinued colonial elements. This transformation can be interpreted as the decolonisation of midwifery. Midwives and dukun beranak were the available options for assisting in the labour of an Indonesian woman. The Indonesian government had a different approach to the colonial government toward society and dukun beranak and built cooperation between midwives and the dukun beranak. The cooperative work among midwives and dukun beranak changed awareness of Indonesian women’s reproductive health matters. This article traces efforts to provide safer childbirth services by looking at the problem through the lens of midwives and dukun beranak relations. The evolution of this relationship shows the decolonisation process inside midwifery and childbearing services.

DETEKSI DINI PREEKLAMPSI PADA IBU HAMIL DENGAN IMT (INDEKS MASSA TUBUH), ROT (ROLL OVER TEST) DAN MAP (MEAN ARTERI PRESSURE)

Preeclampsia is a pregnancy hypertension disorder that significantly affects the morbidity and mortality of mothers worldwide. Preeclampsia occurs in 5-7% of all pregnancies and is the leading cause of maternal mortality in developing countries. The purpose of this community devotion to detect preeclampsia in pregnant women with body mass index, ROT (Rool Over Test) and, MAP (Mean Arterial Pressure). Method of community service by conducting a collection of pregnant mothers at local midwives in PMB Sumarti, SST at Kapor village, Burneh, Bangkalan, after that gathered all pregnant women on the day of the specified and explained the purpose of devotion and counseling about preeclampsia in pregnant women, continued weighing weight, measuring height and measured Body Mass Index (BMI), performing blood pressure measurements in pregnant women through ROT and MAP and performed Interviews with providing questionnaires, giving an explanation of preeclampsia early detection on pregnant women, explaining how to prevent and what to do if preeclampsia, monitoring every month until birth. The results of this community devotion from 16 pregnant mothers who performed preeclampsia detection with BMI, ROT, and MAP were obtained 3 (18.75)% positive preeclampsia because there are 2 positive signs after the examination of the sign seen from MAP ≥ 90 and BMI ≥ 30. The Conclusion that early detection of preeclampsia is necessary to prevent complications during pregnancy, childbirth and postpartum.