Assessment of pre-eclampsia screening services during antenatal care visits at Bungoma County Referral Hospital, Kenya

Janepher Masai, Lameck Diero, Dinah Chelagat


Background: Preeclampsia and eclampsia (PE/E) are major contributors to maternal and neonatal deaths in developing countries, associated with 10–15% of direct maternal deaths and nearly a quarter of stillbirths and newborn deaths, many of which are preventable with improved care.Effective screening for pre-eclampsia services is an excellent way of reducing maternal and neonatal mortality and morbidity.The main objective of this study was to determine the availability preeclampsia screening services that are offered to the pregnant women across the antenatal visits in Bungoma County Referral Hospital.

Methods: This was a cross-sectional descriptive study involving 282 stratified and randomly selected mothers attending ANC services.Data was collected using a pre-tested semi-structured interviewer administered questionnaire. All the analysis was done using Statistical package for Social sciences (SPSS V.20)

Findings: Pre-eclampsia screening services offered included obstetric history (96%), history of twins (88.5%), chronic medical illness (94%) and pressure monitoring (99.6%). Other screening services included urinalysis (49%) and hemoglobintests (65%). Distribution of services decreased steadily from the first to the fourth visitrespectively:

Conclusion and Recommendations: Pre-eclampsia screening services are offered. However, they are not evenly distributed and they decreased progressively through the four scheduled ANC visits. There is need for continuous medical education to midwives on the need for pre-eclampsia screening through all the scheduled antenatal visits. Early antenatal attendanceis mandatory to achieve the four scheduled ANCvisits to enable effective and evenly distribution of pre-eclampsia screening service.

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Akolekar. R., Syngelaki. A., Sarquis, R.,Zvanca, M &Nicolaides K.H (2011). Prediction of early, intermediate and late pre-eclampsia from maternal, biophysical and biochemical markers at 13 weeks. Prenatal diagnosis prenat DIAG2011;31-66-74

Bell, M. J. (2010). A historical Overview of Pre-eclampsia-eclampsia. Job Stet Gynecol Neonatal Nursing. September; 39(5): 510-518

Bungoma County Hospital. Hospital annual report (2012). Unpublished Hospital report

Clinical Protocols and Guidelines Maternity All Sites. Pre-eclampsia and Severe Preeclampsia Guidelines. (2010). Southern Health Version (25):1-10

Churchill, D., Duley, L., Thornton, J., & Jones, L. (2013). Intervention versus expectant care forSevere preeclampsia between 24 and 34 weeks gestation. Cochrane review

Duley, L., Meher, S., &Abalos, E. (2006). Management of pre-eclampsia. BMJ 25 (7539): 463-468.

Duley, L., & Henderson-Smart, D. J. (2009). The global impact of pre-eclampsia and eclampsia. Semin Perinatal 33:130-137.

Duley, L., Henderson –Smart, D., & Chou, D. (2010) Magnesium sulphate versus Phenytoin for

eclampsia.Doi:10.1002/14651858.cd000128[pub].Accessed on 2/8/2013.

Fraser, D. N., Cooper, M. A., & Nolte, A. G. N. (2010). Textbook for Midwives. 2nd Edition. Toronto, Churchill living stone

Homfeyr, J. & Belfort, M. (2009). Proteinuria as a Predictor of Complications of Pre-eclampsia. . Accessed on 3/15/201320 Hospital annual report (2012).

Kenya Demographic and Health Survey (2014). Kenya National Bureau of Statistics- Government of Kenya. Report generated on January 20, 2016

Kenya Demographic and Health Survey 2008-9. Kenya National Bureau of Statistics and ICF macro. Calverton, Maryland: KNBS and ICF Macro

Koki Agarwal (2012). Quality of care for screening and management of pre-eclampsiaand eclampsia. Data Review from six countries. MCHIP/JHPIEGO

Maternal Guidelines Development Group Therapeutic Committee (2011)

Ministry of Medical Services and Ministry of Public Health and Sanitation (2010). National guidelines for quality Obstetrics and Perinatal care. 2010

Ministry of Medical Services and Ministry of Public Health and Sanitation. Service Provision Assessment (SPA) (2010). Nairobi, Kenya

Mclntosh, J.J &Washton, S. (2010).A preeclampsia patient in Kenya. Indiana University. Department of Obstetrics and Gynecology. School of medicine, special deliveryNovember/December 2010

Milne, F., Redman, C., Walker, J, Bradley J., Cooper, C., S, M., Fletcher, G. Jokinen,M., Murphy, D., NiessonPiercy, C. Osgood, V., Robson, S. Shennan.A.,Tuffenel, A& Waugh J. (2005). The Preeclampsia Community Guidelines (PRECOG): How to screen women for and detect onset of preeclampsia in the community. BMJ; 330; 576-580

Osungbade, K. O. &Ige, O. K. (2011). Public health perspective of preeclampsia in developing countries: Implication for health system strengthening. Journal of Pregnancy volume 2012. Doi:10.1155/2011/481093-Pub med

Poon, L.C&Nicolaides, K.H (2014).The first trimester maternal factors and Biomarkers screening for pree-eclampsia. John Wiley &sons Ltd. Harris Birth Research centre of fetal medicine. Kings college, London. UK

Safe Motherhood (2005). Introducing magnesium sulphate for the management of pregnancy induced hypertension. The Safe Motherhood Demonstration Project, Kenya-Ministry of Health. Downloaded on 15/9/2013

Sarsam, D.S., Shamdem, M. &Wazan A.L. R. (2008).Expectant Versus Aggressive Management in Severe Preeclampsia Remote from Term. Singapore Medical Journal;49(9): 698

Simon, E., Caille, A., Perrotin, F., &Giraudeau, B. (2013). Mixing nulliparous and multiparous women in randomized controlled trial of preeclampsia prevention in data base: Evidence from a systematic review

Tavassoli, F., Ghasemi, M., Ghomian, N., Ghorbani, A. and Tavassol, S. (2010). Maternal and perinatal outcome in nulliparous women complicated with pregnancy hypertension. Journal of Pakistan medical association JPMA; 60:70713.

World Health Organization Fact sheet; May 2012: Preeclampsia and Maternal Mortality: a Global Burden.

Urassa, D.P., Carlstedt, A., Nymstom, L., Massawe, S.N. &Linnmark, G. (2006). Eclampsia in Dareesalam, Tanzania-incidence outcome and the role of antenatal care. ActaObstetriciaet Gynecological; 85:571-578

Uzan, J., Carbonnel, M., Piconne, O., Asmar, R. &Ayoubi, J. (2011).Pre-eclampsia:pathophysiology, diagnosis and management .Vascular Health Management; 7:467-474.

Wagner, (2004)). Diagnosis of pre-eclampsia. AM fam physician Dec 15; 70 (12):2317-2324


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