title: Maternal and fetal outcomes after introduction of magnesium sulphate for treatment of preeclampsia and eclampsia in selected secondary facilities: a low-cost intervention.
abstract: The aim of this study was to evaluate whether a new low-cost strategy for the introduction of magnesium sulphate (MgSO4) for preeclampsia and eclampsia in low-resource areas will result in improved maternal and perinatal outcomes. Doctors and midwives from ten hospitals in Kano, Nigeria, were trained on the use of MgSO4. The trained health workers later conducted step-down training at their health facilities. MgSO4, treatment protocol, patella hammer, and calcium gluconate were then supplied to the hospitals. Data was collected through structured data forms. The data was analyzed using SPSS software. From February 2008 to January 2009, 1,045 patients with severe preeclampsia and eclampsia were treated. The case fatality rate for severe preeclampsia and eclampsia fell from 20.9 % (95 % CI 18.7-23.2) to 2.3 % (95 % CI 1.5-3.5). The perinatal mortality rate was 12.3 % as compared to 35.3 % in a center using diazepam. Introduction of MgSO4 in low-resource settings led to improved maternal and fetal outcomes in patients presenting with severe pre-eclampsia and eclampsia. Training of health workers on updated evidence-based interventions and providing an enabling environment for their practice are important components to the attainment of the Millennium Development Goals (MDG) in developing countries.
authors.affiliation: Department of Obstetrics and Gynaecology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria. jtukur@yahoo.com
authors.forename: Jamilu
authors.initials: J
authors.lastname: Tukur
authors.forename: Babatunde
authors.initials: B
authors.lastname: Ahonsi
authors.forename: Salisu Mohammed
authors.initials: SM
authors.lastname: Ishaku
authors.forename: Idowu
authors.initials: I
authors.lastname: Araoyinbo
authors.forename: Ekechi
authors.initials: E
authors.lastname: Okereke
authors.forename: Ayodeji Oginni
authors.initials: AO
authors.lastname: Babatunde
mesh_terms: D004461:Eclampsia / Q000188:drug therapy* / Q000401:mortality; D019317:Evidence-Based Medicine; D005260:Female; D006282:Health Personnel / Q000193:education; D006784:Hospitals, Teaching; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008428:Maternal Mortality / Q000639:trends*; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D054238:Perinatal Mortality / Q000639:trends*; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000401:mortality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012720:Severity of Illness Index; D015149:Tocolytic Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015149:Tocolytic Agents; D008278:Magnesium Sulfate