妊娠期高血压疾病(HDP)是孕产妇发病和死亡的主要原因。预计将最佳利用其产后管理的可用指南。这项研究旨在确定尼日利亚选定的三级医院对指南的遵守情况。它嵌套在2017年10月至2018年6月期间在8个设施中交付的HDP女性队列中。分娩后九周,他们的病例根据预设指标进行评估,并辅以访谈.使用描述性分析确定对指南的遵守程度,包括频率,百分比,means,和标准偏差,以及图表。在366名参与者中,33(9%),75(20%),200(55%),58(16%)患有慢性高血压,妊娠期高血压,先兆子痫,和子痫,分别。只有大约三分之一的人在产后3到5天之间测量了血压。同样,1/3的持续性高血压患者(≥140/90mmHg)在产后1周内未服用抗高血压药物.此外,37%和42%的参与者没有接受过避孕药和随后的早期产前检查的咨询,分别。在先兆子痫/子痫患者中,93%的人没有进行产后血栓预防筛查。尽管所有患有先兆子痫/子痫的妇女在出院后两周仍保持高血压,只有24%的人接受了医学审查。总的来说,在所有HDP和先兆子痫/子痫特异性指标中,只有58%和44%的指标得到遵守,分别。尼日利亚三级医院对HDP产后管理指南的依从性较差。建议优先考虑指南的制度化,并将其与从孕前到长期产后护理的整个连续体联系起来。
Hypertensive disorders in pregnancy (HDPs) are a leading cause of maternal morbidity and mortality. Available
guidelines for their postpartum management are expected to be optimally utilized. This study aimed to determine adherence to
guidelines in selected Nigerian tertiary hospitals. It was nested in a cohort of women with HDPs who delivered in eight facilities between October 2017 and June 2018. Nine weeks after delivery, their cases were evaluated on prespecified indicators and supplemented with interviews. The level of adherence to the
guidelines was determined using descriptive analyses, including frequencies, percentages, means, and standard deviations, as well as charts. Of the 366 participants, 33 (9%), 75 (20%), 200 (55%), and 58 (16%) had chronic hypertension, gestational hypertension, preeclampsia, and eclampsia, respectively. Only about a third had their blood pressure measured between postpartum days three and five. Similarly, a third of those with persistent hypertension (≥140/90 mmHg) were not on antihypertensive medications within the first week postpartum. In addition, 37% and 42% of participants were not counseled on contraceptives and early subsequent antenatal visits, respectively. Among those with preeclampsia/eclampsia, 93% were not offered postpartum screening for thromboprophylaxis. Although all women with preeclampsia/eclampsia remained hypertensive two weeks after discharge, only 24% had medical reviews. Overall, only 58% and 44% of indicators were adhered to among all HDPs and preeclampsia/eclampsia-specific indicators, respectively. Level of adherence to
guidelines on postpartum management of HDPs in Nigerian tertiary hospitals is poor. It is recommended that institutionalization of
guidelines be prioritized and linked to the entire continuum from preconception through longer term postpartum care.