title: [Severe pre-eclampsia. An evidence-based practice proposal].
abstract: OBJECTIVE
  There are several treatment proposals for the obstetric patient with pre-eclampsia, but there is limited evidence on the adequacy of standard treatment. International healthcare organisations recommend that hospitals or anaesthesia departments have written guidelines, protocols or recommendations for dealing with common or severe situations. We propose evidence-based recommendations for the treatment of pre-eclampsia.
  
  
  METHODS
  A literature review was performed using several sources, bibliography databases, recommendations made by specialist societies, and reviews. Four anaesthesiologists reviewed the references selected, in order to design clinical questions (these were obtained from recent pre-eclampsia review articles). Consensus of at least 3 out of 4 experts was required. The Oxford criteria for evidence were chosen to classify the scientific articles, and the Jadad score was applied to the final articles selected.
  
  
  RESULTS
  A total of 50 clinical questions were designed and answered. These were classified into: general questions, influence of the type of delivery, pre-anaesthesia evaluation, peripartum treatment (including analgesia and anaesthesia), eclampsia, post-delivery period, and intensive care and transport. Most of the responses showed low scientific evidence.
  
  
  CONCLUSIONS
  Evidence-based recommendations for severe pre-eclampsia treatment were provided with special emphasis on the anaesthesiologist point of view.
authors.affiliation: Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Consorcio Hospital General Unversitario, Valencia, España. Electronic address: errando013@gmail.com.
authors.forename: C L
authors.initials: CL
authors.lastname: Errando
authors.forename: P
authors.initials: P
authors.lastname: Pérez-Caballero
authors.forename: S
authors.initials: S
authors.lastname: Verdeguer-Ribes
authors.forename: M
authors.initials: M
authors.lastname: Vila-Montañés
mesh_terms: D016362:Analgesia, Obstetrical / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods; D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002585:Cesarean Section; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods; D004461:Eclampsia / Q000503:physiopathology / Q000628:therapy; D019317:Evidence-Based Medicine; D005104:Expert Testimony; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D016343:Monitoring, Intraoperative; D017410:Practice Guidelines as Topic; D011225:Pre-Eclampsia / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D011300:Preoperative Care; D011644:Puerperal Disorders / Q000517:prevention & control; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents
keywords: Anestesia obstétrica; Eclampsia; Evidence-based medicine; Medicina basada en la evidencia; Obstetric anaesthesia; Obstetricia; Obstetrics; Pre-eclampsia; Preeclampsia; Recomendaciones; Recommendations