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Pharmacotherapy for preeclampsia in low and middle income countries: an analysis of essential medicines lists.

Lalani, S; Firoz, T; Magee, LA; Sawchuck, D; Payne, B; Gordon, R; Vidler, M; von Dadelszen, P (2013) Pharmacotherapy for preeclampsia in low and middle income countries: an analysis of essential medicines lists. Journal of Obstetrics and Gynaecology Canada, 35 (3). pp. 215-223. ISSN 1701-2163 https://doi.org/10.1016/S1701-2163(15)30993-2
SGUL Authors: von Dadelszen, Peter

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Abstract

OBJECTIVE: To determine the prevalence of drugs for comprehensive management of preeclampsia in national essential medicine lists (EMLs) in low and middle income countries (LMICs) METHODS: We collected EMLs from the 144 LMICs identified by the World Bank through broad-based Internet searches and in collaboration with the World Health Organization. We identified therapies for hypertension, eclampsia, preeclampsia complications (e.g., pulmonary edema, thrombosis), preterm birth, and labour induction contained in the EMLs. RESULTS: In 91 EMLs obtained from 144 LMICs, the most commonly listed parenteral antihypertensive therapies were verapamil (63.7%), hydralazine (61.5%), sodium nitroprusside (48.3%), and propranolol (39.6%). The most prevalent oral antihypertensive therapies were nifedipine (95.6%), methyldopa (93.4%), propranolol (90.1%), and atenolol (87.9%). For eclampsia/preeclampsia, magnesium sulphate was present in 84.6% of EMLs and calcium gluconate in 85.7%. For pulmonary edema, most EMLs (94.5%) listed oral furosemide, for thrombosis 92.3% listed heparin, for acceleration of fetal pulmonary maturity 90.1% listed parenteral dexamethasone, and for labour induction 97.8% listed oxytocin or a prostanoid (usually misoprostol, 40.7%). CONCLUSION: EMLs of LMICs provide comprehensive coverage of preeclampsia pharmacotherapy. These EMLs may be used as advocacy tools to ensure the availability of these therapies within each country.

Item Type: Article
Additional Information: © 2013 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved. Made available with permission from the publisher. Contact publisher for any further re-use.
Keywords: Antihypertensive Agents, Betamethasone, Developing Countries, Dexamethasone, Diuretics, Eclampsia, Female, Fibrinolytic Agents, Glucocorticoids, Heparin, Humans, Magnesium Sulfate, Oxytocics, Oxytocin, Pre-Eclampsia, Pregnancy, Pulmonary Edema, Thromboembolism, Tocolytic Agents, Humans, Pulmonary Edema, Eclampsia, Pre-Eclampsia, Thromboembolism, Magnesium Sulfate, Betamethasone, Dexamethasone, Oxytocin, Oxytocics, Tocolytic Agents, Heparin, Antihypertensive Agents, Fibrinolytic Agents, Diuretics, Glucocorticoids, Pregnancy, Developing Countries, Female, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Journal of Obstetrics and Gynaecology Canada
ISSN: 1701-2163
Language: eng
Dates:
DateEvent
1 March 2013Published
Publisher License: Publisher's own licence
PubMed ID: 23470109
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107527
Publisher's version: https://doi.org/10.1016/S1701-2163(15)30993-2

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