Challenges associated with hypertensive disease during pregnancy in low-income countries

Objective: To assess the challenges associated with the diagnosis, management, and prevention of hypertensive disease during pregnancy in low-income countries, following the success of the Magpie Trial. Methods: Descriptive review of the literature from 1990 to 2009 on the diagnosis, management, and prevention of hypertensive disease in pregnancy. Results: In the absence of credible measures to predict and prevent hypertension in pregnancy, diagnosis and treatment remain the only viable options, although they are still associated with important challenges in low-income countries. Despite the presence of high-quality evidence that magnesium sulfate is safe and effective at preventing and treating eclampsia, its use is extremely limited in many low-income countries. Conclusion: There is a need for cheap and reliable tools with which to address the diagnostic, preventive, and management challenges associated with hypertensive disease during pregnancy in low-income countries. It is recommended that such countries incorporate magnesium sulfate protocols into their national health and/or practice policies. (C) 2010 Intemational Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.