TY  - BOOK
AU  - Jacob, Rose 
AU  - Ng'walida,  N. N. M 
TI  - Risk Factors and Complications of Preeclampsia In Pregnant Women at Seukotoure Regional Refferal Hospital Mwanza Tanzania
PY  - 2017///
CY  - Mwanza, Tanzania: 
PB  -  Catholic University of Health and Allied Sciences [CUHAS – Bugando],   Phone: +255 28 298 3384,   Fax: +255 28 298 3386,   Email: vc@bugando.ac.tz,   Website: www.bugando.ac.tz  : 
KW  -  
N2  - Abstract:

Pre-eclampsia is a major cause of maternal and fetal mortality and morbidity. The incidence of pre-eclampsia is 2-10%, depending on the population studied and definition of pre-eclampsia with the exception of smoking the literature has not been systematically reviewed for factors that predict for relative risk of developing pre-eclampsia, the recent national institute for clinical excellence (NICE) guideline of antenatal care have reduced the number of antenatal visit recommended for healthy women at low risk. As the ranomised controlled trial on which this recommendations were based never powered to identify important outcome such as mortality and the failure to act on knows risk factorsat booking contribute to death from preeclampsia, so it’s important to define risk at the beginning of pregnancy. Therefore, these shortcomings encouraged me to go at seuko toure regional referral hospital in Mwanza Tanzania, and one month in the department of obstetrics and gynecology during my elective/attachment period to learn more about the risk factors and complications of pre-eclampsia which I believe it will be helpful to my community in the future.

The most practical works which I did/learnt include, the management of preeclampsia where by in mild to moderate preeclampsia we give the patient bed rest, planned antennal visit every two weeks up to 32/40 then weekly, a balanced diet, methyldopa tab 250-500mg tds, delivery at 38 weeks gestation. In severe preeclampsia we admit the patient to the hospital, give the patient bed rest, monitor urine input and output, measure blood pressure hourly, give the patient hydralazine 5mg iv slowly over half an hour while monitoring vitals each half an hour, nifedipine sublingual every four hours until diastolic bp falls to 100mmhg, magnesium sulfate injection 10mls of 50% solution deep am, also we deliver the patient within 6-8hours if the blood pressure is not improving. I also assisted in the delivery of patients with preeclampsia, I also assisted in the c/s of patients who could not have a spontaneous virginal delivery, I attended clinic days which were on Tuesday and Thursday to follow up patients with preeclampsia, I took a full history in each patient with preeclampsia and did physical examination

During this elective I observed several challenges in the care of patients, which included inadequate of basic working tools/instrument iv cannulas, syringes, delivery set, PV set, lack of set lack of sterile groves, urine dipstick.

Inadequate number of beds where patients had to share beds increasing the risk of nosocomial infection to the patients who are admitted to the ward. Inadequate number of staffs, the nurses, doctors and specialist to take care of all the patient leading to long working hours of the available staffs
Low wages of the staff members who tend to have a low motivation in taking care of the patients.

Inadequate diagnostic devices such as laboratory reagents, ultrasound, computed tomography (CT) scan, Electrocardiogram (ECG)

The most challenge was the poor social economic status of patients who because of lack of money they could not afford to buy medications all getting most of the services hence leading to complications of preeclampsia.

Conclusion: the government it needed in raising the standard of health service provision providing drugs, tool and instruments which are needed in the management of patients. Government should support and encourage and motivate health practioners, early detection of risk factors and prevention of complication in patients with preeclampsia and proper counseling and encouraging patients on adherence to medications are very important in the management and prevention of complications of diseases

ER  -