Population Council Research that makes a difference

APHA 139th Annual Meeting and Exposition
29 October–2 November 2011

Abstract

"Magnesium sulfate use for the treatment of severe pre-eclampsia and eclampsia in Oaxaca state, Mexico"
Marieke G. Van Dijk, Mónica Garcia Rojas, Xipatl Contreras, Jorge Valencia, and Sandra Garcia

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 pre-eclampsia/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 pre-eclampsia/eclampsia in the rural state of Oaxaca, in 2009 we reviewed medical charts of 502 women suffering severe pre-eclampsia/eclampsia in the state's ten 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 pre-eclampsia, magnesium sulfate was administered in 16 percent of the first visits to health facilities with an increase to 79 percent 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 percent of first visits, and its usage decreased to under 7 percent 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 pre-eclampsia/eclampsia in the rural state of Oaxaca, Mexico.
• Analyze its use over four medical visits.

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