Preeclampsia World Day was celebrated on May 22. During an awareness-raising activity, which took place in the Ministry of Public Health with the support of the Juan Rassmuss Echecopar Foundation; Dr. Diego Núñez made a presentation about preeclampsia in the Paraguayan context. In the following interview we talk with him about the topic discussed on that occasion.

We heard in your speech that Preeclampsia is currently the first cause of maternal death in Paraguay. Tell us more about this, doctor, and your vision on how to improve this situation

When talking about pathologies, since the year 2017, the complications from preeclampsia occupy the first place in terms of mortality and also morbidity among the women of our country. That is worrisome for two reasons; first, because complications are often preventable and also because we currently have well-established protocols within the Ministry of Health for the management of pre-eclampsia, and yet it seems that the management is not yet applied correctly. There are tools that we provide to professionals throughout the health system, such as guidelines, regulations and protocols that we elaborate in matters of health for the public and private sector, but we must still insist on doing the correct things.

¿What data do you have regarding maternal mortality in Paraguay?

Making a comparative analysis between the data from 2018, and the 2019 data up to the month of May, there has been an increase in maternal deaths, mainly from the complications due to preeclampsia, postpartum hemorrhage, asepsis and abortions.

Another subject of concern is the large percentage of teenage pregnancies: more than 20% of total pregnancies correspond to the adolescent population and within the adolescent group, preeclampsia is also the first cause of mortality. The same occurs with another high risk group within adolescent pregnancy, which is the indigenous population, where preeclampsia also occupies the first place of maternal death.

¿What actions is the Ministry of Health taking regarding this issue?

In order to do prevention, we need to raise people’s awareness on the importance of early prenatal control. Then, the health professional would simply need to follow the established protocols. Last year we published a manual of obstetric pathologies, which is a step-by-step guide for the professional who must perform a prenatal consultation, which is also a way to reduce the rates of preeclampsia. There are also guidelines for preeclampsia and the diagnosis that cannot be avoided any longer. In those cases we apply the red code, which also teaches professionals the steps that they should follow, and how to act in each case. In addition, there is a committee to monitor maternal and neonatal mortality, where all cases of complications and maternal deaths are studied, performing an intervention in each hospital center where the patient passed to study the background, the mistake committed and work on how to improve. 

¿In your opinion, what role does the collaboration of the Juan Rassmuss Echecopar Foundation have in the prevention of this disease?

The Foundation helps us a lot with the promotion. Before, Preeclampsia was a very poorly known issue, but now there is a better awareness. The initiative implemented by the Foundation foresees everything that should be done in all hospitals: counseling, the evaluation of risk factors, adequate blood pressure measurements. It is also very positive to provide high-risk pregnant women with manual blood pressure taking devices, which help a lot thanks to the easy understanding for patients of the “traffic light” system.

About Diego Núñez:

He is a specialist in Gynecology and Obstetrics, graduated from the Faculty of Medical Sciences of the National University of Asunción. He works as a doctor on duty at the Hospital of Clinics, and currently holds a position in the Ministry of Public Health, serving as head of the Department of Integral Health for Men and Women, under the Directorate of Sexual and Reproductive Health.

As a member of the technical team of the Ministry of Health, he conducts training sessions nationwide on all issues related to Sexual and Reproductive Health, other issues such as obstetric emergencies, red code, family planning and is now initiating with his team a new project “Prenatal”, focusing on the difficulties and errors that are found in the service of the different hospital centers.