A Story of Hope and Professionalism: Overcoming Severe Preeclampsia in Kyrgyzstan

Dinara Mambeitalieva, Head of the Department of Anesthesiology and Resuscitation at the Perinatal Center in Bishkek, shared such story:

"A pregnant woman at 25-26 weeks gestation was admitted to us with severe symptoms of preeclampsia: severe edema, headache, high blood pressure - 150 over 110. Despite her threatening condition, she left our department, having written a refusal. Two weeks later, the woman returned, but already in critical condition. Her blood pressure reached 160-170, the baby in the womb stopped growing, the edema became massive, and her kidneys were barely functioning," recalls Dinara Samаganovna.

The decision to perform an emergency cesarean section was the only chance to save both lives. The baby was born with a weight of 1700 grams and was connected to a ventilator. "Fortunately, the woman survived, her blood pressure and general condition began to improve," the doctor adds.

In Kyrgyzstan, the difficulties in diagnosing and treating pre-eclampsia are related not only to medical aspects, lack of systematic training, but also to the refusal of medical co-operation.

Ainagul Kasymbaeva, Head of the Maternity Department of the Jalal-Abad Regional Clinical Hospital, emphasizes: "We are faced with a lack of training and continuous education, and the staff turnover is high, which also exacerbates the problem. We have a well-established scheme for transferring patients from the far districts: the blood pressure of women in labor is lowered, all data on their condition is recorded, magnesium therapy is connected, and they are transferred to us. Training sessions, like the one held in October 2024 in Jalal-Abad, are aimed at developing the skills of specialists to improve the quality of medical care and achieve better outcomes for women with severe preeclampsia and its main complications. This is achieved by building capacity in the area of timely diagnosis and treatment."

One of the participants, an anesthesiologist at the Osh Interregional United Clinical Hospital, Zhapar uulu Ermek, notes: "At this training, we learned about new methods of magnesium therapy and exchanged experiences. Such events help to create a unified approach among our colleagues to the treatment of severe preeclampsia and improve results across the country."

Preeclampsia and eclampsia are the leading causes of maternal and perinatal mortality in the Kyrgyz Republic. However, competent pregnancy management and timely assistance can prevent most deaths. Clinical protocols for preeclampsia and eclampsia have been adopted in the country, but their effective implementation requires regular practical training for medical personnel.

"During the training sessions, we focus on practical skills and situations such as the administration of magnesium with a syringe pump. This eliminates the human factor and increases the chances of successful treatment. In magnesium therapy, accuracy is important, and the syringe pump has a specific dosage at which an anticonvulsant effect is achieved. In the practical sessionы, each of the training participants was able to establish a calculated constant rate of magnesium management. The participants also reviewed, played out, and jointly analyzed various situations from practice," explains Dinara Samаganovna.

The UN South-South Cooperation initiative was launched as a quality assurance initiative to improve maternal health indicators. Funded by the India-UN Development Partnership Fund, it aims to reduce preventable maternal morbidity by improving access to quality health services through the use of the Obstetric Surveillance and Response System (OSRS) and teleconsultations in five pilot maternity hospitals in Kyrgyzstan.

The project is supported and implemented by the Ministry of Health of the Kyrgyz Republic and the United Nations Population Fund (UNFPA).