Strategies to prevent eclampsia in a developing country: I. Reorganization of maternity services

AM McCaw-Binns, DE Ashley, LP Knight, I MacGillivray, J Golding

Research output: Contribution to journalArticle (Academic Journal)

31 Citations (Scopus)

Abstract

Objective: To determine whether changes in primary and secondary care service delivery could prevent antenatal eclampsia. Method: One intervention (St. Catherine) and two control (St Ann, Manchester) parishes were chosen. The health system in St. Catherine was restructured. Primary antenatal clinics had clear instructions for referring patients to a high-risk antenatal clinic or to hospital. Guidelines were provided to high-risk clinics and the antenatal ward for appropriate treatment of hypertension and preeclampsia when induction of labor should occur. Antenatal eclampsia incidence was monitored before and during the intervention and compared with control parishes (no intervention). Each eclampsia case was investigated to identify inadequacies in the system. Results: The process resulted in better identification of women at risk. Antenatal eclampsia incidence dropped dramatically as care improved. Compared with control areas, by completion of the study, the rate was significantly lower than at the start: OR 0.19 (95% CI: 0.13–0. 27; p
Translated title of the contributionStrategies to prevent eclampsia in a developing country: I. Reorganization of maternity services
Original languageEnglish
Pages (from-to)286 - 294
Number of pages9
JournalInternational Journal of Gynecology and Obstetrics
Volume87 (3)
DOIs
Publication statusPublished - Dec 2004

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