Table 4 Potential effect of prevention and treatment of HDP on maternal mortality from HDP using evidence from systematic reviews, historical trends and fatality rates in SAMM from HDP
Health system level at which intervention is delivered | Intervention | Risk reduction on HDP-related mortality | Source of effectiveness estimate |
|---|---|---|---|
Health centre | Calcium supplementation during pregnancy | 20% | Systematic review of effect of routine calcium supplementation versus placebo on death/serious morbidity[40] |
(L)District or secondary hospital | Calcium supplementation during pregnancy | 20% | Systematic review of effect of routine calcium supplementation versus placebo on death/serious morbidity[40] |
MgS04 for pre-eclampsia | 59% | Systematic review of effect of MgS04 versus placebo for treatment of pre-eclampsia on eclampsia[45] | |
MgS04 for eclampsia | 41% | Systematic review of effect of MgS04 versus diazepam for treatment of eclampsia on death[42] | |
Antenatal screening for hypertension and proteinuria and treatment of pre-eclampsia and eclampsia with MgS04 and early delivery in women with severe pre-eclampsia and eclampsia | 84-99% | Case fatality rates in SAMM from HDP in Indonesia[78]and Bolivia[79]and historical trends in HDP mortality in China and Sri Lanka | |
Tertiary hospital | All the above plus treatment of severe hypertension in pregnancy and referral to specialist intensive care for women with severe complications | 99% | Historical trends in HDP mortality in Sweden and England & Wales |