Improving pre-eclampsia care with the web

Dec 08, 2010 By Cath Harris

Problems related to pregnancy claim the lives of hundreds of thousands of women every year. Almost all of these deaths are in developing countries – the countries least able to provide effective medical care.

Pre-eclampsia is a serious problem of and causes the deaths of more than 60,000 women annually, and many of their babies. There is huge potential to reduce these fatalities in developing nations.

The ambition of Dr. Stephen Kennedy, head of Oxford’s Nuffield Department of Obstetrics & Gynaecology, is to help achieve this by educating health professionals globally on all aspects of maternal health. His vision is being backed by The John D & Catherine T MacArthur Foundation , which is funding the development of web-based materials to improve pre-eclampsia care.

Pre-eclampsia is characterized by high blood pressure and protein in the urine and, if left untreated, can cause strokes, kidney and liver damage, and death. The condition usually develops after the 20th week of pregnancy with early delivery of the baby the usual treatment. It is much rarer in developed countries where the drug magnesium suplhate, the most effective treatment, has been available at low cost for 20 years.

There are three obstacles preventing improvements in pre-eclampsia care in poorer countries: the absence of national guidelines based on effective treatments, too few specialists, and scarce supplies of magnesium sulphate, also known as Epsom salts.

To tackle the first of these problems, Oxford University is joining forces with eXact learning solutions, a provider of online distance learning material.

With the Nuffield Department of Obstetrics & Gynaecology and the Oxford Maternal & Perinatal Health Institute the company is developing a web-based training pilot for midwives, nurses and doctors. The material will be used initially in hospitals in India, Mexico and Nigeria, where pre-eclampsia is most common.

The initiative is being funded by The John D & Catherine T MacArthur Foundation which stepped in after a conference in 2007 hosted jointly by Oxford University and EngenderHealth. Delegates called for magnesium sulphate to be readily available in developing world hospitals together with training and protocols in its use.

The partners’ long-term objective is to offer the training course worldwide. Dr. José Villar, who is leading Oxford University’s work with eXact learning solutions, said: "Treatment for pre-eclampsia should be equally available in and the developed world.

"Our work with eXact learning solutions will make significant inroads into improving global healthcare for those suffering . The aim now is to win additional funding to develop this pilot initiative into a far larger program of education and treatment."

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