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Table 3 Identified scopes for improvement for Indonesian HDP management following comparison with international guidelines

From: Developing management pathways for hypertensive disorders of pregnancy (HDP) in Indonesian primary care: a study protocol

All pregnant women should have an initial assessment of risk factors of HDP and or preeclampsia, such as previous preeclampsia, chronic hypertension, any related comorbidities, and age during pregnancy.
The women’s blood pressure should be checked at each antenatal visit.
Low dose aspirin is prescribed for women with high risks of preeclampsia.
Low dose aspirin is prescribed for women with high risks of preeclampsia from 12th week of pregnancy until the baby’s delivery.
Calcium supplementation is prescribed for women with low calcium intake to prevent the event of preeclampsia.
Women are asked about signs and symptoms of preeclampsia, such as headache, blurred visions, cramps, seizure, eclampsia feet, in each antenatal visit.
Proteinuria/Dipstick test should be done at least once in each trimester.
Once the Dipstick test are positive, the pregnant women are checked with any indicators of preeclampsia, such as: kidney function test, complete blood count, and liver function test.
Once diagnose with preeclampsia, women are assigned for referral.
Telephone communication with obstetricians prior to the referral to the hospital.
Paramedic companion during the referral, completed with adequate emergency kits ambulance.
Antihypertensive agents for the treatment of severe hypertensive disorder of pregnancy, such as calcium channel blockers, or methyldopa-should be available in the practice settings.
Antihypertensive agents were considered once the women’s blood pressure reached SBP > 150 and or DBP > 100.
Antihypertensive agents were prescribed without any delays once the women’s blood pressure reached SBP > 160 and or DBP > 110.
Obstetricians led delivery is booked once women are diagnosed with the hypertensive disorders in pregnancy.
Monitoring of sign and symptoms of preeclampsia, includes laboratories examination should be available in practice settings.
Magnesium sulphate IV/IM should be available for the emergency treatment of eclampsia.
The full regimens of magnesium sulphate IV/IM as treatment for eclampsia seizures.
Women should be checked for any signs and symptoms of hypertensive disorder of pregnancy (HDP) and or preeclampsia at maximum of six week postpartum in primary care clinics.
Almost of antihypertensive agents are safe during breastfeeding periods.
Postpartum counselling about the risks of cardiovascular diseases for women with previous history of HDP.
Women with history of HDP are offered with non-hormonal contraception.
Periodic blood measure monitoring and cardiovascular assessment for women with history of HDP
Counseling about lifestyle modification is offered for women with history of HDP
Consideration of low dose of aspirin prescription for the next pregnancy.