title: Use of magnesium sulfate for treatment of pre-eclampsia and eclampsia in Mexico.
abstract: OBJECTIVE
  To establish a baseline of magnesium sulfate utilization prior to publication of the updated 2006 technical guidelines on pre-eclampsia and eclampsia in Mexico, and to examine barriers to treating pregnant women with magnesium sulfate as perceived by maternal health experts.
  
  
  METHODS
  In collaboration with the Federal Ministry of Health, medical charts were reviewed for 87 maternal deaths due to hypertensive disorders that occurred in Mexico in 2005. Evidence was gathered on whether magnesium sulfate had been indicated or administered. In-depth interviews with experts were conducted to identify barriers to treatment utilization.
  
  
  RESULTS
  Magnesium sulfate had been used in 37.5% of severe pre-eclampsia and 47.7% of eclampsia cases. Thematic analysis of expert interview data revealed 4 primary barriers to the implementation of evidence-based guidelines and use of magnesium sulfate: lack of knowledge of magnesium sulfate, lack of acceptance, drug-related barriers, and insufficient monitoring or supervision. It was found that magnesium sulfate was not the treatment used for Mexican women who died of pregnancy-related hypertensive disorders in public facilities, and there was suboptimal implementation of evidence-based practices and official guidelines.
  
  
  CONCLUSIONS
  The results highlight barriers to magnesium sulfate use, which constitutes a significant gap in treating women with eclampsia in Mexico.
authors: Population Council, Mexico Office, Mexico City, Mexico.
authors: Marieke G
authors: MG
authors: van Dijk
authors: Claudia
authors: C
authors: Díaz Olavarrieta
authors: Patricia Uribe
authors: PU
authors: Zuñiga
authors: Rufino Luna
authors: RL
authors: Gordillo
authors: Maria-Elena Reyes
authors: ME
authors: Gutiérrez
authors: Sandra G
authors: SG
authors: García
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002423:Cause of Death; D004461:Eclampsia / Q000188:drug therapy* / Q000503:physiopathology; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008800:Mexico; D017410:Practice Guidelines as Topic; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D008278:Magnesium Sulfate