The Ukrainian experience for effective management of severe preeclampsia

Abstract

Preeclampsia (PE) is main cause of morbidity and mortality both mother and fetus. Preeclampsia occurs in 3- 12% of pregnancy and that was no changed during the last century. Advances in obstetrics and neonatology have substantially mitigated many of the adverse pregnancy outcomes related to PE. The PE encompasses 2% to 8% of pregnancy-related complications, greater than 50,000 maternal deaths, and over 500,000 fetal deaths worldwide. Material and Methods. The new version of the Ukrainian National Clinical Guideline and Clinical Protocol "Hypertensive disorders during pregnancy, childbirth and the postpartum period" 2022 presents a synthesis of the scientific evidence that is relevant to the concerning severe PE treatment strategies. The current algorithm was performed at the National Pirogov Memorial Medical University, Vinnytsya, Ukraine, under budget grant No. 0121 U109141. Results. We presented the new algorithm of clinical management for severe pre-eclampsia "CALM DOWN" that implemented to the new Ukrainian clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care. CALM DOWN is the special mnemonic that means "step by step strategy" for the medical teamwork. Conclusion. We have proposed the algorithm "CALM DOWN" for the optimal timing of severe PE, offers to systematize the participation of each member of the team in the provision of emergency care and should be implemented in clinical practice based on the peculiarities of the specifics of work, resources, functioning and localization of the maternity facilities when forming personal route of the patient.