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Eclampsia in Scandinavia: incidence, substandard care, and potentially preventable cases

Andersgaard, Alice Beathe; Herbst, Andreas LU ; Johansen, Marianne; Ivarsson, Anna; Ingemarsson, Ingemar LU ; Langhoff-Roos, Jens; Henriksen, Tore; Straume, Bjorn and Oian, Pal (2006) In Acta Obstetricia et Gynecologica Scandinavica 85(8). p.929-936
Abstract
Background. Description of incidence, clinical signs, symptoms, and consequences of eclampsia in Scandinavia, and assessment of substandard care and potential preventability. Methods. A descriptive cohort study including all women giving birth in a 2-year period (mid-1998-mid-2000) in Scandinavia. Notifications of eclampsia cases were obtained from all obstetric units at 3-monthly intervals. All patient files were reviewed, and systematic audit was performed to identify potentially preventable cases by using predefined criteria. Main outcome measures. Signs and symptoms preceding the eclamptic seizure, the standard of medical care, maternal and perinatal morbidity, and mortality were all recorded. Potentially preventable cases through... (More)
Background. Description of incidence, clinical signs, symptoms, and consequences of eclampsia in Scandinavia, and assessment of substandard care and potential preventability. Methods. A descriptive cohort study including all women giving birth in a 2-year period (mid-1998-mid-2000) in Scandinavia. Notifications of eclampsia cases were obtained from all obstetric units at 3-monthly intervals. All patient files were reviewed, and systematic audit was performed to identify potentially preventable cases by using predefined criteria. Main outcome measures. Signs and symptoms preceding the eclamptic seizure, the standard of medical care, maternal and perinatal morbidity, and mortality were all recorded. Potentially preventable cases through improved care and cases eligible for primary prophylactic magnesium sulfate (MgSO4) were estimated. Results. The incidence of eclampsia was 5.0/10 000 maternities (CI = 4.3-5.7/ 10 000). Eighty-six percent had a diagnosis of pre-eclampsia before the seizure. Nine of 10 had at least one physical complaint before the first seizure, severe headache being the most common symptom, occurring in two-thirds. Most seizures (90%) occurred after admission to hospital. By audit, 89 cases (42%) were classified as having received substandard care. Prophylactic use of magnesium sulfate might have reduced the number of eclampsia cases by 35 (17%). Conclusions. Eclampsia occurred mainly in hospital and the majority of women had symptoms heralding the seizure. In retrospect, nearly half of the cases were found potentially preventable by timely intervention, improved medical care, and systematic use of prophylactic treatment with MgSO4. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
preventability, potential, incidence, clinical signs and symptoms, eclampsia, substandard care
in
Acta Obstetricia et Gynecologica Scandinavica
volume
85
issue
8
pages
929 - 936
publisher
Wiley-Blackwell
external identifiers
  • pmid:16862470
  • wos:000240284400006
  • scopus:33746375398
ISSN
1600-0412
DOI
10.1080/00016340600607149
language
English
LU publication?
yes
id
cfcb96f7-78c5-4f17-89c4-172b738f1950 (old id 394917)
date added to LUP
2007-08-31 13:58:14
date last changed
2019-10-08 02:09:38
@article{cfcb96f7-78c5-4f17-89c4-172b738f1950,
  abstract     = {Background. Description of incidence, clinical signs, symptoms, and consequences of eclampsia in Scandinavia, and assessment of substandard care and potential preventability. Methods. A descriptive cohort study including all women giving birth in a 2-year period (mid-1998-mid-2000) in Scandinavia. Notifications of eclampsia cases were obtained from all obstetric units at 3-monthly intervals. All patient files were reviewed, and systematic audit was performed to identify potentially preventable cases by using predefined criteria. Main outcome measures. Signs and symptoms preceding the eclamptic seizure, the standard of medical care, maternal and perinatal morbidity, and mortality were all recorded. Potentially preventable cases through improved care and cases eligible for primary prophylactic magnesium sulfate (MgSO4) were estimated. Results. The incidence of eclampsia was 5.0/10 000 maternities (CI = 4.3-5.7/ 10 000). Eighty-six percent had a diagnosis of pre-eclampsia before the seizure. Nine of 10 had at least one physical complaint before the first seizure, severe headache being the most common symptom, occurring in two-thirds. Most seizures (90%) occurred after admission to hospital. By audit, 89 cases (42%) were classified as having received substandard care. Prophylactic use of magnesium sulfate might have reduced the number of eclampsia cases by 35 (17%). Conclusions. Eclampsia occurred mainly in hospital and the majority of women had symptoms heralding the seizure. In retrospect, nearly half of the cases were found potentially preventable by timely intervention, improved medical care, and systematic use of prophylactic treatment with MgSO4.},
  author       = {Andersgaard, Alice Beathe and Herbst, Andreas and Johansen, Marianne and Ivarsson, Anna and Ingemarsson, Ingemar and Langhoff-Roos, Jens and Henriksen, Tore and Straume, Bjorn and Oian, Pal},
  issn         = {1600-0412},
  keyword      = {preventability,potential,incidence,clinical signs and symptoms,eclampsia,substandard care},
  language     = {eng},
  number       = {8},
  pages        = {929--936},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Eclampsia in Scandinavia: incidence, substandard care, and potentially preventable cases},
  url          = {http://dx.doi.org/10.1080/00016340600607149},
  volume       = {85},
  year         = {2006},
}