Hypertensive Disorders of Pregnancy in Low-Resource Settings

Hypertensive disorders of pregnancy encompass a spectrum of conditions—from gestational hypertension to pre-eclampsia and eclampsia—that remain a leading cause of maternal and perinatal morbidity and mortality in resource-constrained regions. These disorders typically present after 20 weeks of gestation and are characterised by elevated blood pressure, proteinuria and end-organ dysfunction. In low-resource settings, challenges include limited access to accurate blood pressure monitoring, shortages of skilled healthcare personnel, intermittent supplies of essential medications and variable referral pathways. Community detection often relies on minimally trained health workers using basic equipment, while facility-based care may suffer from overcrowding and insufficient protocols for timely intervention. Sociocultural factors, such as low health literacy and financial barriers, further impede early recognition and adherence to treatment plans. Despite these obstacles, recent advances in community engagement, digital decision support and simplified treatment regimens have demonstrated potential to improve early detection, ensure appropriate escalation of care and reduce adverse outcomes.

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Hypertensive Disorders of Pregnancy in Low-Resource Settings publication trend

The graph below shows the total number of articles in hypertensive disorders of pregnancy in low-resource settings across all publications each year (not limited to Nature Index journals).

Technical terms

Gestational hypertension: New-onset elevation of blood pressure (≥140/90 mmHg) after 20 weeks of gestation without proteinuria or end-organ signs.

Pre-eclampsia: A multisystem disorder characterised by hypertension after 20 weeks' gestation accompanied by proteinuria or evidence of maternal organ dysfunction (renal, hepatic, neurological).

Eclampsia: The occurrence of convulsions in a woman with pre-eclampsia not attributable to other causes, representing a severe progression of the disorder.

Community health worker: A lay or auxiliary health provider trained to perform basic screening, health education and referral in underserved settings.

References

1. Choosing blood pressure thresholds to inform pregnancy care in the community: An analysis of cluster trials. BJOG An International Journal of Obstetrics & Gynaecology (2023).
2. Provision and experience of care among women with hypertension in pregnancy: a multi-center qualitative study in Ghana. Reproductive Health (2023).
3. The incidence of pregnancy hypertension in India, Pakistan, Mozambique, and Nigeria: A prospective population-level analysis. PLOS Medicine (2019).