VALIDATION OF A PRE-ECLAMPSIA MONITORING TOOL (PETOGRAPH) AMONG PREGNANT MOTHERS IN JINJA REGIONAL REFERRAL HOSPITAL: A CROSS-SECTIONAL STUDY. Presented at the Association of Obstetricians and Gynaecologists Uganda ANNUAL SCIENTIFIC CONFERENCE 2017.

1. VALIDATION OF A PRE-ECLAMPSIA MONITORING TOOL
(PETOGRAPH) AMONG PREGNANT MOTHERS IN JINJA
REGIONAL REFERRAL HOSPITAL: A CROSS-SECTIONAL STUDY
Presented at
AOGU ANNUAL SCIENTIFIC CONFERENCE 2017
By
Abubakar Suleiman Tsamiya
Principal Director GPI

2. Suleiman Abubakar-Tsamiya1,2, Shilpy Chakraborty3, Nirav Hitesh Kumar
Valand3; Marta Vicente-Crespo2, 3, #
1School of Clinical Medicine, Kampala International University Western
Campus, Ishaka, Uganda;
2Global Pre-Eclampsia Initiative, Kampala, Uganda;
3School of Medicine, St. Augustine International University, Kampala,
Uganda;
#corresponding author: mvicentecrespo@saiu.ac.ug

3. TOP 10 COUNTRIES IN THE WORLD
WITH THE HIGHEST MATERNAL DEATH 13% CAUSED BY PRE-ECLAMPSIA
Nigeria
33%
India
25%
DR CONGO
12%
Ethiopia
6%
Pakistan 5%
Tanzania 5%
Kenya 5%
Uganda
3%
Bangladesh
3%
Chad 3%
MDG MORTALITY REVIEW 2015

4. BOTTLE NECKS TO
REDUCING PRE-ECLAMPSIA BURDEN
EXTERNAL BOTTLE NECKS
SCARCE
DATA
POOR FUNDING
FEW
RESEARCHES
INTERNAL BOTTLE NECKS
Maternal
Morbidity
and Mortality
from Pre-
eclampsia
Delay in
Detection
Late
Referral
Poor
Manage
ment
Inefficient
Follow-up

5. BACKGROUND
Pre-eclampsia: 1st cause of preventable maternal death in developed countries, 2nd
in developing countries.
pre-eclampsia claims the lives of more than 70,000 women per year (1 per 6min)
and more than 500,000 of their fetuses and newborns.
 Complicates 2-10% of All Pregnancies
key variables that need improvement (FIGO report 2016):
early detection;
timely referral;
appropriate management;
efficient follow up.
We propose a series of measures to address the identified four stages in the clinical
course of the disease reporting.
In this paper: preliminary validation of the Petograph™ form, a monitoring tool for
appropriate management of pre-eclampsia in low resource environments.

6. METHODS
A cross-sectional study was carried out using a systematic
sampling for a period of 1 year (between July 2016 and
June 2017).
At Jinja Regional Referral Hospital Uganda in July 2017
169 pre-eclamptic mothers out of 4987 deliveries
A checklist was used to correlate the information found on
the PETOGRAPH™ to that of the existing patient records.

7. RESULTS
Pre-eclampsia
3%
Normal
97%
PRE-ECLAMPSIA PREVALENCE

8. Current records vs Petograph™
100 100 100 100
16
33
27.5
4
0
20
40
60
80
100
120
Clinical Presentations Feto-maternal wellbeing Management Modalities &
Outcome
Baseline Investigations
Percentage
Coverage
Record Parameter
PETOGRAPH EXISTING RECORD SYSTEM Linear (PETOGRAPH)

9. CONCLUSIONS
1. There were big gaps in the medical records available for the pre-
eclampsia patients that received attention at the Jinja Regional
Referral Hospital.
2. Most of the records are missing key information about the
management and outcome of the disease, which would be most
helpful in investigations about risk factors and disease progression
markers.
3. The Petograph™ form would provide a clear template to guide the
data recording exercise and facilitate appropriate management of
the disease as it is developing and more inquisitive research on the
disease afterwards.

10. RECOMMENDATIONS
1. Holistic Approach to tackle hypertensive disorders in pregnancy
2. Ensure inter-professional collaboration (E.g. Ugandan Heart
Institute, “National Kidney Institute”)
3. Technical collaboration with relevant Organizations Like Global
Preeclampsia Initiative (GPI)- PETOGRAPH™
4. Design, Develop and Dedicate to an “African Roadmap” that is
non external donor dependent to combat the threat of Pre-
eclampsia in Uganda, Africa and the world in collaboration with
GPI (African Centre for Preeclampsia Research)

11. WAY FORWARD USING PETOGRAPH
Poor
Management and
Inefficient
Follow-up
• PETOGRAPH Form
• PETOGRAPH Desktop Application
• PETOGRAPH Android Application
Delay in
Detection
• PETOGRAPH
Android Application Late
Referral
• PETOGRAPH Android
Application

12. IMPACT OF PETOGRAPH
INNOVATION
Primary
Level
Intervention
Secondary
Level
Intervention
Tertiary
Level
Intervention
Efficient
Follow-up
Effective
Management
Early
Detection
Timely
Referral
PETOGRAPH
FORM
PETOGRAPH
ANDROID APP
PETOGRAPH
DESKTOP APP

13. SUMMARY
• Uganda is the 8th Country with highest Maternal Death in the World
• A mother dies of Pre-eclampsia every 6 minutes
• External and Internal Bottle Neck towards reduction of maternal Mortality
and Morbidity identified
• A cross-sectional study carried out At Jinja Regional Referral Hospital
Uganda in July 2017 to validate an innovative tool the PETOGRAPH™
• Significant gaps were identified in the existing medical record.
• The Petograph™ innovation could be used to address the global mystery of
preeclampsia.
• Holistic Approach, inter-professional collaboration, strategic partnerships
and “African Approach” Identified as key players in Achieving SDG 3.1
(From 366 to 70 per100,000 live Birth).

14. ACKNOWLEDGMENT
GPI BOARD
Professor Sadiq Yusuf
Professor Ahmed Adedeji
Dr Marta Vicente-Crespo
Dr Aluonzi Burhan
Lucy Den Teuling
Immaculate Tusiime
Abubakar Suleiman Tsamiya
PETOGRAPH TEAM
Professor Ivan Bonet Fonseca
Dr Marta Vicente-Crespo
Mugasho Lincoln,
Saviour Muzoora
Aliyu Usman Muhammad
Mugizi Maurice
Mukhaye Miria Viveca
Abubakar Suleiman Tsamiya

15. THANK YOU FOR LISTENING