Timeliness of care for eclampsia and pre-eclampsia in Benin, Ecuador, and Jamaica.
OBJECTIVE
Cases meeting diagnostic criteria for severe pre-eclampsia or eclampsia were reviewed in three countries to determine timeliness and effectiveness of care.


METHODS
Cases were retrospectively selected from 11 emergency obstetric care facilities and medical records reviewed by trained obstetricians.


RESULTS
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.


CONCLUSIONS
Timeliness can be studied in developing countries. Its objective measurement is a first step towards improving this component of care.
Edson
W
W
Quality Assurance Project, University Research Co., LLC, Bethesda, Maryland 20814, USA. wedson@toadmail.com
Burkhalter
B
B
McCaw-Binns
A
A
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001541:Benin; D003906:Developing Countries; D004461:Eclampsia / Q000188:drug therapy* / Q000628:therapy; D004484:Ecuador; D004632:Emergency Medical Services / Q000592:standards; D005260:Female; D006801:Humans; D007563:Jamaica; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011225:Pre-Eclampsia / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011787:Quality of Health Care; D012189:Retrospective Studies; D013997:Time Factors
D000927:Anticonvulsants; D000959:Antihypertensive Agents