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PE/E Management Strategies at different levels

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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  1. PE/E Management Strategies at different levels Pius Okong M.Med, PhD Associate Professor Nsambya Hospital, FIGO SM&NHC

  2. 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 ?

  3. 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

  4. 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

  5. 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

  6. CEmONC Facilities Who? • Midwives • Doctors • Anaethetists • Laboratory tech

  7. 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.

  8. 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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