International Academy of Perinatal Medicine (IAPM) guidelines for screening, prediction, prevention and management of pre-eclampsia to reduce maternal mortality in developing countries

J Perinat Med. 2021 Dec 22;51(2):164-169. doi: 10.1515/jpm-2021-0636. Print 2023 Feb 23.

Abstract

Approximately 800 women die from pregnancy or childbirth-related complications around the world every day, 99% of which occur in developing countries. In majority of cases deaths are related to pre-eclampsia and eclampsia. The purpose of new adjusted and simplified IAPM guidelines is specifically lowering maternal mortality by decreasing preventable deaths in developing countries (particularly in remote rural areas) by using rather cheap medicines used to control chronic and gestational hypertension, prevent pre-eclampsia in high-risk pregnancies and treat severe pre-eclampsia and eclampsia. IAPM guidelines should be implemented and evaluated in each developing country respecting specific problems, needs and resources. It is of essential importance to: 1. Identify specific high-risk pregnancies, 2. Commence timely appropriate ASA and calcium supplementation, 3. Organize basic antenatal care and adequate referral of pregnancies with early onset of pre-eclampsia to the appropriate institutions and ensure induction of labour in well-equipped delivery facility for women with near-term and term pre-eclampsia 4. Ensure magnesium sulphate availability to prevent severe pre-eclampsia and eclampsia-related maternal deaths, and 5. Identify specific barriers for implementation of these guidelines and correct them accordingly. Only by systematic implementations of these guidelines, we may have a chance to decrease the mortality of pre-eclampsia an its complications as a killer number one of mothers in developing countries.

Keywords: developing countries; guidelines; maternal mortality; pre-eclampsia.

MeSH terms

  • Developing Countries
  • Eclampsia* / diagnosis
  • Eclampsia* / prevention & control
  • Female
  • Humans
  • Magnesium Sulfate / therapeutic use
  • Maternal Mortality
  • Pre-Eclampsia* / diagnosis
  • Pre-Eclampsia* / prevention & control
  • Pregnancy

Substances

  • Magnesium Sulfate