title: Clinical practice patterns on the use of magnesium sulphate for treatment of pre-eclampsia and eclampsia: a multi-country survey.
abstract: OBJECTIVE
  To characterise the current clinical practice patterns regarding the use of magnesium sulphate (MgSO4) for eclampsia prevention and treatment in a multi-country network of health facilities and compare with international recommendations.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A total of 147 health facilities in 15 countries across Africa, Latin America and Asia.
  
  
  METHODS
  Heads of obstetric departments or maternity units.
  
  
  METHODS
  Anonymous online and paper-based survey conducted in 2015.
  
  
  METHODS
  Availability and use of MgSO4; availability of a formal clinical protocol for MgSO4administration; and MgSO4dosing regimens for eclampsia prevention and treatment.
  
  
  RESULTS
  Magnesium sulphate and a formal protocol for its administration were reported to be always available in 87.4% and 86.4% of all facilities, respectively. MgSO4was used for the treatment of mild pre-eclampsia, severe pre-eclampsia and eclampsia in 24.3%, 93.5% and 96.4% of all facilities, respectively. Regarding the treatment of severe pre-eclampsia, 26.4% and 7.0% of all facilities reported using dosing regimens that were consistent with Zuspan and Pritchard regimens, respectively. Across regions, intramuscular maintenance regimens were more commonly used in the African region (45.7%) than in the Latin American (3.0%) and Asian (22.9%) regions, whereas intravenous maintenance regimens were more often used in the Latin American (94.0%) and Asian (60.0%) regions than in the African region (21.7%). Similar patterns were found for the treatment of eclampsia across regions.
  
  
  CONCLUSIONS
  The reported clinical use of MgSO4for eclampsia prevention and treatment varied widely, and was largely inconsistent with current international recommendations.
  
  
  CONCLUSIONS
  MgSO4regimens for eclampsia prevention and treatment in many hospitals are inconsistent with international recommendations.
authors.affiliation: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Q
authors.initials: Q
authors.lastname: Long
authors.affiliation: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: O T
authors.initials: OT
authors.lastname: Oladapo
authors.affiliation: King Edward Memorial Hospital for Women, Perth, WA, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Leathersich
authors.affiliation: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: J P
authors.initials: JP
authors.lastname: Vogel
authors.affiliation: Centro Rosarino de Estudios Perinatales, Rosario, Argentina.
authors.forename: G
authors.initials: G
authors.lastname: Carroli
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Lumbiganon
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya.
authors.forename: Z
authors.initials: Z
authors.lastname: Qureshi
authors.affiliation: UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: A M
authors.initials: AM
authors.lastname: Gülmezoglu
mesh_terms: D000349:Africa; D001208:Asia; D003430:Cross-Sectional Studies; D004461:Eclampsia / Q000188:drug therapy*; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data*; D006801:Humans; D007843:Latin America; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011225:Pre-Eclampsia / Q000188:drug therapy*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D015149:Tocolytic Agents / Q000627:therapeutic use*
chemical_list: D015149:Tocolytic Agents; D008278:Magnesium Sulfate
keywords: dosing regimen; eclampsia; low- and middle-income settings; magneisum sulphate; pre-eclampsia