Errors in the treatment of hypertensive disorders of pregnancy and their impact on maternal mortality

• Published in: International journal of gynecology and obstetrics 2013-04, Vol.121 (1), p.78-81
• Main Authors: Zuleta-Tobón, John J, Pandales-Pérez, Heleodora, Sánchez, Sandra, Vélez-Álvarez, Gladis A, Velásquez-Penagos, Jesús A
• Format: Article
• Language: English
• Subjects: Adult; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - therapeutic use; Colombia; Delivery of Health Care - standards; Female; Humans; Hypertension, Pregnancy-Induced - diagnosis; Hypertension, Pregnancy-Induced - mortality; Hypertension, Pregnancy-Induced - therapy; Maternal Mortality; Medical Errors - statistics & numerical data; Obstetrics and Gynecology; Pre-eclampsia; Pre-Eclampsia - diagnosis; Pre-Eclampsia - mortality; Pre-Eclampsia - therapy; Pregnancy; Pregnancy Outcome; Quality of Health Care; Referral and Consultation - statistics & numerical data; Retrospective Studies; Severity of Illness Index; Substandard care; Young Adult
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/j.ijgo.2012.10.031

Abstract Objective To describe the patients' characteristics and the factors that contributed to the maternal deaths associated with hypertensive disorders of pregnancy that occurred in the department of Antioquia, Colombia, from 2004 through 2011. Methods A committee of experts conducted a retrospective descriptive study to analyze the information obtained from both mandatory reports of health facilities to the Public Health Surveillance System and interviews with family members. Results From 2004 through 2011, there were 720 170 births and 389 maternal deaths in the Department of Antioquia, and 70 of the deaths were due to hypertensive disorder of pregnancy. The factors that most contributed to the deaths were a lack of emergency administration of antihypertensive drugs (64.6%); the inadequate administration of antihypertensive drugs (58.8%); retaining the patient at a health facility ill equipped to treat her appropriately for her clinical state (54.7%); untimely referral or inadequate conditions for transfer (50.8%); and an error in classifying the severity of the disorder, which prevented appropriate management (49.1%). Conclusion A substandard quality of care was the determining factor in the deaths of women who presented with hypertensive disorders of pregnancy.