Development and use of quality of care indicators for obstetric care in women with preeclampsia, severe preeclampsia, and severe morbidity.
OBJECTIVE
To develop indicators for evaluating the quality of care in managing preeclampsia.


METHODS
An expert group helped to develop and validate the following indicators for evaluating quality of care: availability of intensive care; completeness of laboratory tests; appropriateness of drug treatment at admission and before delivery (antihypertensive drugs, anticonvulsants, and dexamethasone); gestational age at which pregnancy should be interrupted; and type of delivery. By using these indicators, it was possible to evaluate the quality of care in 432 patients with preeclampsia.


RESULTS
A significant percentage of patients with preeclampsia and "near misses" received low quality of care, regardless of disease severity.


CONCLUSIONS
A number of interventions are needed to increase the quality of care to help avert maternal deaths in patients with preeclampsia.
Pérez-Cuevas
Ricardo
R
Epidemiology and Health Services Research Unit, CMN Siglo XXI, Instituto Mexicano del Seguro Social, Mexico. ricardo.perezcuevas@imss.gob.mx
Morales
Hortensia Reyes
HR
Doubova
Svetlana Vladislavovna
SV
Murillo
Vitelio Velasco
VV
D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000592:standards; D005260:Female; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D010343:Patient Admission / Q000592:standards; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies; D019984:Quality Indicators, Health Care