124 Evaluation of the hospital management of pre-eclampsia and eclampsia leading to maternal death

• Published in: Pregnancy hypertension 2016-07, Vol.6 (3), p.240-241
• Main Authors: Bordinoski, Luciana Ferreira, da Silva, Kátia Silveira, Pereira de Sousa, Francisco Lazaro, Fonseca, Vânia Matos, Bastos Dias, Marcos Augusto
• Format: Article
• Language: English
• Subjects: Cardiovascular; Obstetrics and Gynecology
• ISSN: 2210-7789
• DOI: 10.1016/j.preghy.2016.08.206

Introduction Brazil’s Piauí State mortality rate one of the highest, mainly regarding hypertension. Evaluate adequate adhesion guidelines could be relevant. Objective Evaluate management of pre-eclampsia and eclampsia in maternal deaths in Piauí regarding Brazil’s Health Ministry High Risk Pregnancy Manual recommendations (2010)1. Method This is an observational study of deaths due to hypertensive syndromes which occurred between 2010-2013 in Brazil’s Piauí State. Data were collected from medical records in 2014. Socio-demographic and obstetric profile, trajectory by women, assistance in the first 24 h of admission during labor and delivery and newborn care were studied. A matrix was elaborated to evaluate the adequacy of clinical and hospital obstetrical care and which was adopted to the women with preeclampsia and eclampsia who died, the definition of evaluation criteria established according to the recommendations of the Techinical Manual of High Risk Pregnancy of the Ministry of Health/Brazil (2010). The database was developed in Microsoft Excel 2010 spreadsheet and the Epi-Info version 3.5.2. was used for analysis. This study was done according to the Committee’s ethical approval. Results The study numbered 43 deaths per hypertensive syndrome. Most of the women were young, black and had a low education level. Half of the women traveled at least 103 km for assistance. During the first 05 days of hospitalization, 70% of deaths occurred, with 90.7% in the postpartum period. In clinical evaluation, 83.7% had severe preeclampsia symptoms, but laboratory research for HELLP syndrome did not reach 70% of women and did not identify proteinuria dosage record. Seizure was present in 36.1% of cases. 13.5% had high blood pressure measured as recommended by the manual. Concerning administration of fast action hypotensive, 58% of women treated with it, were adequate, and hydralazine being the most used drug. The magnesium sulfate loading dose was in agreement with recommended only at 2.3% of the cases and the maintenance dose at 14%, and in 83% of cases the duration of administration was less than 24 hours. Of the pregnant women who gave birth in the reference hospital, 93.7% had blood pressure recorded in medical records during labor or delivery and delivery mode was cesarean section in 75% of cases. There is no record of the use of the partograph, when recommended. Perinatal mortality in the reference hospital was 50%. Conclusion The main conducts adopted are in d