title: Pharmacotherapy for preeclampsia in low and middle income countries: an analysis of essential medicines lists.
abstract: OBJECTIVE
  To determine the prevalence of drugs for comprehensive management of preeclampsia in national essential medicine lists (EMLs) in low and middle income countries (LMICs)
  
  
  METHODS
  We collected EMLs from the 144 LMICs identified by the World Bank through broad-based Internet searches and in collaboration with the World Health Organization. We identified therapies for hypertension, eclampsia, preeclampsia complications (e.g., pulmonary edema, thrombosis), preterm birth, and labour induction contained in the EMLs.
  
  
  RESULTS
  In 91 EMLs obtained from 144 LMICs, the most commonly listed parenteral antihypertensive therapies were verapamil (63.7%), hydralazine (61.5%), sodium nitroprusside (48.3%), and propranolol (39.6%). The most prevalent oral antihypertensive therapies were nifedipine (95.6%), methyldopa (93.4%), propranolol (90.1%), and atenolol (87.9%). For eclampsia/preeclampsia, magnesium sulphate was present in 84.6% of EMLs and calcium gluconate in 85.7%. For pulmonary edema, most EMLs (94.5%) listed oral furosemide, for thrombosis 92.3% listed heparin, for acceleration of fetal pulmonary maturity 90.1% listed parenteral dexamethasone, and for labour induction 97.8% listed oxytocin or a prostanoid (usually misoprostol, 40.7%).
  
  
  CONCLUSIONS
  EMLs of LMICs provide comprehensive coverage of preeclampsia pharmacotherapy. These EMLs may be used as advocacy tools to ensure the availability of these therapies within each country.
authors.affiliation: Faculty of Medicine, University of British Columbia, Vancouver BC.
authors.forename: Shifana
authors.initials: S
authors.lastname: Lalani
authors.affiliation: Clinician Investigator Program, Department of Medicine, University of British Columbia, Vancouver BC.
authors.forename: Tabassum
authors.initials: T
authors.lastname: Firoz
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Obstetric Medicine, Children's and Women's Hospital and Health Centre, Vancouver BC.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Magee
authors.affiliation: Child and Family Research Institute, University of British Columbia, Vancouver BC; PRE-EMPT Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Diane
authors.initials: D
authors.lastname: Sawchuck
authors.affiliation: PIERS Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Beth
authors.initials: B
authors.lastname: Payne
authors.affiliation: PRE-EMPT Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Gordon
authors.affiliation: CLIP Program, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Marianne
authors.initials: M
authors.lastname: Vidler
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Children's and Women's Health Centre of BC, University of British Columbia, Vancouver BC.
authors.forename: Peter
authors.initials: P
authors.lastname: von Dadelszen
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000627:therapeutic use; D003906:Developing Countries; D003907:Dexamethasone / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004461:Eclampsia / Q000188:drug therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D010120:Oxytocics / Q000627:therapeutic use; D010121:Oxytocin / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000188:drug therapy*; D011247:Pregnancy; D011654:Pulmonary Edema / Q000188:drug therapy / Q000209:etiology; D013923:Thromboembolism / Q000188:drug therapy / Q000209:etiology; D015149:Tocolytic Agents / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics; D005343:Fibrinolytic Agents; D005938:Glucocorticoids; D010120:Oxytocics; D015149:Tocolytic Agents; D010121:Oxytocin; D008278:Magnesium Sulfate; D003907:Dexamethasone; D006493:Heparin; D001623:Betamethasone