W Edson1, B Burkhalter, A McCaw-Binns. 1. Quality Assurance Project, University Research Co., LLC, Bethesda, Maryland 20814, USA. wedson@toadmail.com
Abstract
OBJECTIVE: Cases meeting diagnostic criteria for severe pre-eclampsia or eclampsia were reviewed in three countries to determine timeliness and effectiveness of care. METHOD: Cases were retrospectively selected from 11 emergency obstetric care facilities and medical records reviewed by trained obstetricians. RESULT: Of 91 cases (Benin, 28; Ecuador, 25; Jamaica, 38), 74% were correctly treated with anticonvulsant and 77% with antihypertensive therapy. The median interval to treat eclampsia (anticonvulsant, 28 min; antihypertensive, 77 min) was shorter than for severe pre-eclampsia (anticonvulsant, 45 min; antihypertensive, 85 min). Two in three cases (65%) received anticonvulsant but only 41% received antihypertensive therapy within 60 min of diagnosis. While 74% of eclamptics had been delivered within 12 h, only 39% of severe pre-eclamptics were delivered within 24 h. CONCLUSION: Timeliness can be studied in developing countries. Its objective measurement is a first step towards improving this component of care.
OBJECTIVE: Cases meeting diagnostic criteria for severe pre-eclampsia or eclampsia were reviewed in three countries to determine timeliness and effectiveness of care. METHOD: Cases were retrospectively selected from 11 emergency obstetric care facilities and medical records reviewed by trained obstetricians. RESULT: Of 91 cases (Benin, 28; Ecuador, 25; Jamaica, 38), 74% were correctly treated with anticonvulsant and 77% with antihypertensive therapy. The median interval to treat eclampsia (anticonvulsant, 28 min; antihypertensive, 77 min) was shorter than for severe pre-eclampsia (anticonvulsant, 45 min; antihypertensive, 85 min). Two in three cases (65%) received anticonvulsant but only 41% received antihypertensive therapy within 60 min of diagnosis. While 74% of eclamptics had been delivered within 12 h, only 39% of severe pre-eclamptics were delivered within 24 h. CONCLUSION: Timeliness can be studied in developing countries. Its objective measurement is a first step towards improving this component of care.
Authors: Joyce L Browne; Sabine W van Nievelt; Emmanuel K Srofenyoh; Diederick E Grobbee; Kerstin Klipstein-Grobusch Journal: PLoS One Date: 2015-04-29 Impact factor: 3.240