Shifana Lalani1, Tabassum Firoz2, Laura A Magee3, Diane Sawchuck4, Beth Payne5, Rebecca Gordon6, Marianne Vidler7, Peter von Dadelszen8. 1. Faculty of Medicine, University of British Columbia, Vancouver BC. 2. Clinician Investigator Program, Department of Medicine, University of British Columbia, Vancouver BC. 3. Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Obstetric Medicine, Children's and Women's Hospital and Health Centre, Vancouver BC. 4. Child and Family Research Institute, University of British Columbia, Vancouver BC; PRE-EMPT Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC. 5. PIERS Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC. 6. PRE-EMPT Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC. 7. CLIP Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC. 8. Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Children's and Women's Health Centre of BC, University of British Columbia, Vancouver BC.
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.
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.
Authors: Asif R Khowaja; Craig Mitton; Stirling Bryan; Laura A Magee; Zulfiqar A Bhutta; Peter von Dadelszen Journal: Implement Sci Date: 2015-05-26 Impact factor: 7.327
Authors: Lisiane Freitas Leal; Sonia Marzia Grandi; Vanessa Iribarrem Avena Miranda; Tatiane da Silva Dal Pizzol; Robert William Platt; Mariângela Freitas da Silveira; Andréa Dâmaso Bertoldi Journal: Int J Environ Res Public Health Date: 2020-11-18 Impact factor: 3.390