Hypertensive disorders during pregnancy are some of the leading causes of global maternal morbidity and mortality, with pre-eclampsia/eclampsia accounting for the greatest disease burden. The World Health Organization defines pre-eclampsia as the “onset of a new episode of persistent hypertension during pregnancy.” Pre-eclampsia generally onsets after 20 weeks of pregnancy but can occur up to six weeks post-delivery and may involve damage to the kidneys, brain or other organs.
Research strongly suggests that maternal deaths due to pre-eclampsia/eclampsia are almost entirely preventable with timely and effective care, including the administration of antihypertensive medications to control blood pressure, magnesium sulfate to prevent eclampsia (seizures) and eventual delivery of the newborn.
Nevertheless, the nature of pre-eclampsia as a syndrome poses a number of challenges to timely diagnosis. Pre-eclampsia manifests differently from patient to patient. Additionally, its symptoms, which include headache, swelling, nausea/vomiting, abdominal pain, vision changes, and sudden weight gain, are not unique to pre-eclampsia, making it easy to misdiagnose as gallbladder issues, “white coat hypertension,” the flu, a neurological condition or “normal” pregnancy symptoms.
A patient’s lack of understanding of the signs and symptoms of the disease can impact her likelihood of seeking timely care. Recent research from the analysis of state-level maternal mortality by the California Maternal Quality Care Collaborative (CMQCC) emphasizes that patient understanding of symptoms and the severity of the disease is crucial for improving outcomes and preventing maternal death.
The CMQCC analysis found that “delays in seeking care” and “lack of knowledge regarding the severity of a symptom” contributed to more than half of all hypertensive-related maternal mortality cases. These potential barriers to seeking care are an even greater threat to women in low-resource settings, making early detection through patient education necessary for preventing adverse outcomes globally. When women know how to recognize the signs and symptoms of pre-eclampsia, they are more likely to seek care and comply with prescribed treatments.
Pre-eclampsia patient education tools should answer four basic questions:
- What is pre-eclampsia?
- What are the risks associated with pre-eclampsia?
- What are the signs and symptoms of pre-eclampsia?
- What should patients do if they notice any of the signs and symptoms of pre-eclampsia?
Easy-to-understand, image-based educational materials could be the key to ensuring that women across the globe can recognize the signs and symptoms of pre-eclampsia and understand the severity of the disease. A 2004 study conducted in Jamaica found that a pictographic maternal education card contributed to early reporting of symptoms and a 70% reduction in eclampsia cases in the region.
The Preeclampsia Foundation worked with a health services research team at Northwestern University to test the effectiveness a tool for improving patient understanding of the condition. The results showed that patients who received the tool scored significantly better on a pre-eclampsia knowledge assessment than those who received a text-based pamphlet or no additional information, even among women with lower health literacy levels.
About the Preeclampsia Foundation: The Preeclampsia Foundation is a U.S.-based 501(c)(3) non-profit organization established in 2000. As the nation’s only patient advocacy organization dedicated to hypertensive disorders of pregnancy, the Foundation works to achieve its mission by raising public awareness, providing patient support and education, improving healthcare practices, and catalyzing research. The Foundation envisions a world where preeclampsia and related hypertensive disorders of pregnancy no longer threaten the lives of mothers and their babies.
Read the latest MHTF Quarterly highlighting pre-eclampsia/eclampsia.
Read community perceptions of pre-eclampsia/eclampsia from around the world.
Learn more about pre-eclampsia/eclampsia on the MHTF website.