244822 Magnesium sulfate use for the treatment of severe preeclampsia and eclampsia in Oaxaca state, Mexico

Wednesday, November 2, 2011: 11:06 AM

Marieke G. Van Dijk, MD, MA , Population Council, Mexico, Mexico
Mónica Garcia Rojas, MD, Epidemiologist , Dirección de Prevención y Promoción a la Salud, Servicios de Salud de Oaxaca, Oaxaca, Mexico
Xipatl Contreras, BA , Population Council Mexico Office, Mexico City, Mexico
Jorge Valencia, MSc , Population Council Mexico Office, Mexico City, Mexico
Sandra Garcia, ScD, ScM , Mexico Office, Population Council, Mexico City, Mexico
The most common, yet treatable, cause of maternal death in Mexico is severe pre-eclampsia. If left untreated it can lead to seizures (eclampsia), kidney and liver damage, or death. With the target of the Millennium Development Goals in sight, the Mexican Ministry of Health (MOH) identified preeclampsia/eclampsia as a priority area. The MOH national guidelines indicate magnesium sulfate as the treatment of choice for these conditions, but although it is widely available, previous research suggests it is not routinely or correctly used. To document the use of magnesium sulfate for women with severe preeclampsia/eclampsia in the rural state of Oaxaca, in 2009 we reviewed medical charts of 502 women suffering severe preeclampsia/eclampsia in the state's 10 principal MOH hospitals. The chart review reveals that the majority of women had gone through a trajectory of up to four visits to healthcare facilities. Among women with severe preeclampsia, magnesium sulfate was administered in 16% of the first visits to health facilities with an increase to 79% in the fourth visit, often alongside other anticonvulsant drugs such as phenytoin and diazepam. Conversely, among women with eclampsia magnesium sulfate (alone or combined) was administered in 46% of first visits and its usage decreased to under 7% by the fourth visit. We are analyzing reasons for the differences of magnesium sulfate use in different health facilities, but the findings suggest that magnesium sulfate and additional anticonvulsive drugs are used inconsistently according to the level of care of the hospital and the patient's condition.

Learning Areas:
Basic medical science applied in public health
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Evaluate the use of magnesium sulfate among women with severe preeclampsia/eclampsia in the rural state of Oaxaca, Mexico. Analyze its use over four medical visits.

Keywords: Maternal Health, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I oversee projects on maternal and sexual and reproductive health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Women's Health II
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