261. Strengthening Antenatal Care Services for early detection of Pre-Eclampsia and timely delivery: A Case of Three States in Nigeria

Introduction In Nigeria, maternal deaths due to pre-eclampsia/eclampsia (PE/E) are now the leading cause of maternal mortality at referral facilities’ level. Lack of proper identification and management coupled with delay arrivals at referral facilities have been identified as contributing factors. Objectives This study seeks to understand maternal and newborn outcomes following training and mentoring of primary health care providers in identification and management of women with PE/E in 3 states in Nigeria. Methods Health care providers working at antenatal and maternity units in 36 secondary and 144 primary health care (PHC) facilities were trained and mentored on the prevention, detection and management of PE/E. Service data were extracted from monitoring tool that tracks how women with pre-eclampsia were identified and managed and their childbirth outcomes. Data were entered using Epi Info and analyzed through SPSS software. Results Ninety-three pregnant women were detected to have PE in one year. Sixty-four (68.8%) registered their pregnancies before developing PE, 32 (34.4%) were aged 15–25 years and most were married (n = 74, 79.6%). None of the patients registered before 12-weeks gestational age; 65% (n = 60) had proteinuria >2+; and 74.2% (n = 69) had hypertension of >160/110 mmHg. Seventy percent (n = 65), 25.8% and 1.1% were identified with severe PE, PE and eclampsia, respectively. Of women with severe PE, 60% (n = 39) received MgSO4 while 40% (n = 26) did not. Although most mothers and babies survived, there was three maternal death and thirty perinatal deaths. In ten of the new-borns, death occurs at Discussions Appropriate training and mentoring of lower cadre service providers has the potential to improve detection and management of PE/E at PHC level, but more focus must be made on saving lives born before 36 weeks gestation.