Opportunities for improving hypertensive disorders of pregnancy (HDP) management in primary care settings: a review of international published guidelines in the context of pregnancy care in Indonesia

Abstract Globally, almost maternal mortality caused by HDP occurs in low to middle-income countries (LMIC); yet, limited guidance is available to local primary care practitioners who are usually the main health care providers. This review examined existing international practice guidelines to identify potential practices to improve HDP management in Indonesian primary care. We performed a structured literature search strategies and snowballing search in six databases: MEDLINE, Web of Science, EMBASE, CINAHL, Cochrane reviews and Google Scholar for articles that were published between 2007 and 2018 using relevant keywords and phrases of ‘guidelines’, ‘hypertensive disorders of pregnancy’ or ‘preeclampsia’ and ‘primary care’. The AGREE II instrument was used to assess the quality and reporting of practice guidelines. Thematic analysis was performed in all eligible guidelines and the results were discussed between the authors. Sixteen international practice guidelines or similar forms were reviewed. Almost all of the reviewed guidelines were partially applicable, but some procedures potentially be adopted to Indonesian primary care settings. Three main themes of the potential practice were identified, namely clinical management, care planning, and professional communication. Potential procedures to manage women with HDP in Indonesia have been identified to which perhaps also relevant in other LMIC. Further contextualisation process is required to facilitate their adoption in practice settings.