Pe e management strategies at different levels
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PE/E Management Strategies at different levels. Pius Okong M.Med, PhD Associate Professor Nsambya Hospital, FIGO SM&NHC. Timely management. Elements CEmOC BEmOC Family/Co Diagnosis YES YES Recog

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PE/E Management Strategies at different levels

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PE/E Management Strategies at different levels

Pius Okong M.Med, PhD

Associate Professor

Nsambya Hospital, FIGO SM&NHC


Timely management

Elements CEmOC BEmOC Family/Co

  • Diagnosis YES YES Recog

  • Treat YES Initiate Cont.

  • Monitor YES YES ?

  • Plan delivery YES No No

  • Delivery YES Y/N ?


PE/E Case management

  • Diagnosis

  • Prevent seizures: Min 24 hrs, Mag Sulphate

  • Control/stabilize BP: Antihypertensive IV

  • Evaluate cond. of Baby

  • Evaluate mother: LFT,RFT,CBC

  • Monitoring


Family/Community level

Who?

  • Pregnant woman/support person

  • CHW

    What?

  • Knowledge to recognize seizures and symptoms

  • Plan for emergency, transfer to BeOC facility

    Little or No information on CHW roles? Urine testing at home? Lack of evidence Research


Basic EON Care Facility

Who?

  • Midwives/Lab Assistant

  • Clinical officers/Nurses

    What?

  • Diagnosis: symptoms/exam/urine testing?

  • Initiate Mag Sulphate, Anti HT

  • Monitoring: BP, for seizures, fetus, urine etc

  • Communication/Transfer to CEmONC

    Evidence about early treatment beneficial


CEmONC Facilities

Who?

  • Midwives

  • Doctors

  • Anaethetists

  • Laboratory tech


CEmONC Facilities

What? Processes

  • Emergency preparedness/critically ill patient

  • Drills for the teams?

  • Consumables

  • Tools

  • Use of Mag Sulphate for PE, prenatal and continuing pregnancy

    Evidence about use of Mag/sulphate and timing of delivery etc.


Challenges

Evidence for:

  • Research to fill the gaps at community level: CHW information, diagnosis, urine testing and what medications?

  • Modeling the complex aspects of case management in health facilities

  • Case management audits: accountability and health care quality?


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