OBJECTIVE: In the past ten years effective treatments for pre-eclampsia and eclampsia have been evaluated and identified following large trials and systematic reviews. We investigated the extent of those effective interventions implementation. METHODS: Descriptive analysis of data collected as part of a cluster randomized trial. The trial was assigned the International Standardised Randomized Controlled Trial Number ISRCTN 14055385. Hospitals with more than 1000 deliveries per year not directly associated with an academic institution in Mexico City municipal area in Mexico (n = 22) and the north-east region of Thailand (n = 18) were included. All women delivering at the participating hospitals at two time periods in 2000 and 2002 contributed data on practice rates. The use of magnesium sulfate for pre-eclampsia and eclampsia were the outcomes. FINDINGS:Eight out of 22 hospitals in Mexico (range 0.8% to 8.5%) and all 18 hospitals in Thailand (range 18.6% to 63.6%) usedmagnesium sulfate for women with pre-eclampsia. In Mexico, 11 of 22 hospitals used magnesium sulfate for eclampsia (range 9.1% to 60.0%). In Thailand, all 17 hospitals having eclampsia cases usedmagnesium sulfate (range 25% to 100%). CONCLUSION: Despite compelling evidence, magnesium sulfate use is below desired levels. Clinical practices should be audited and implementation of this effective intervention should be taken up as a priority where universal implementation is not in place.
RCT Entities:
OBJECTIVE: In the past ten years effective treatments for pre-eclampsia and eclampsia have been evaluated and identified following large trials and systematic reviews. We investigated the extent of those effective interventions implementation. METHODS: Descriptive analysis of data collected as part of a cluster randomized trial. The trial was assigned the International Standardised Randomized Controlled Trial Number ISRCTN 14055385. Hospitals with more than 1000 deliveries per year not directly associated with an academic institution in Mexico City municipal area in Mexico (n = 22) and the north-east region of Thailand (n = 18) were included. All women delivering at the participating hospitals at two time periods in 2000 and 2002 contributed data on practice rates. The use of magnesium sulfate for pre-eclampsia and eclampsia were the outcomes. FINDINGS: Eight out of 22 hospitals in Mexico (range 0.8% to 8.5%) and all 18 hospitals in Thailand (range 18.6% to 63.6%) used magnesium sulfate for women with pre-eclampsia. In Mexico, 11 of 22 hospitals used magnesium sulfate for eclampsia (range 9.1% to 60.0%). In Thailand, all 17 hospitals having eclampsia cases used magnesium sulfate (range 25% to 100%). CONCLUSION: Despite compelling evidence, magnesium sulfate use is below desired levels. Clinical practices should be audited and implementation of this effective intervention should be taken up as a priority where universal implementation is not in place.
Authors: J Villar; L Say; A Shennan; M Lindheimer; L Duley; A Conde-Agudelo; M Merialdi Journal: Int J Gynaecol Obstet Date: 2004-06 Impact factor: 3.561
Authors: A Metin Gülmezoglu; José Villar; Jeremy Grimshaw; Gilda Piaggio; Pisake Lumbiganon; Ana Langer Journal: BMC Med Res Methodol Date: 2004-01-15 Impact factor: 4.615
Authors: Godfrey Woelk; Karen Daniels; Julie Cliff; Simon Lewin; Esperança Sevene; Benedita Fernandes; Alda Mariano; Sheillah Matinhure; Andrew D Oxman; John N Lavis; Cecilia Stålsby Lundborg Journal: Health Res Policy Syst Date: 2009-12-30