Nurses’ knowledge of the clinical management of hypertensive disorders of pregnancy in low- and middle-income countries: A narrative review
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Background. Hypertensive disorders of pregnancy (HDP), particularly pre-eclampsia (PE) and eclampsia, are significant contributors to maternal morbidity and mortality worldwide. The exact cause of this pregnancy condition is unknown, and it has no specific treatment apart from delivery of the fetus and placenta. Nurses, especially in low- and middle-income countries (LMICs), play a critical front-line role in identifying women at risk of HDP, initiating clinical management, and ensuring timely referrals to appropriate healthcare facilities.
Objectives. This narrative review aimed to assess the knowledge and practices of professional nurses, including midwives, in identifying women at risk of developing HDP during pregnancy, childbirth and the immediate postpartum period.
Methods. A systematic literature search was conducted using PubMed, Google Scholar and ScienceDirect. Keywords included ‘pre- eclampsia’, ‘nurses’ knowledge’, ‘management of HDP’ and ‘training of nurses’. The search was not restricted by publication year.
Results. The review revealed significant gaps in nurses’ knowledge regarding management of PE. Early identification of women with HDP risk factors during antenatal visits is of critical importance for maternal and fetal health. However, inadequate training on diagnostic criteria, blood pressure measurement techniques, and initial treatment protocols remains a challenge in LMICs. Effective communication between primary healthcare facilities and referral hospitals is essential for managing severe PE and eclampsia.
Conclusion. Despite the provision of guidelines, maternal morbidity and mortality rates remain high in LMICs owing to insufficient training of nurses and resource constraints. Emphasis on mandatory training programmes for all health professionals at primary healthcare level is crucial. Strengthened referral systems are also necessary to improve outcomes for women with HDP.
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