Timeliness of care for eclampsia and pre-eclampsia in Benin, Ecuador, and Jamaica.

OBJECTIVE

Cases meeting diagnostic criteria for severe pre-eclampsia or eclampsia were reviewed in three countries to determine timeliness and effectiveness of care.

METHOD: Cases were retrospectively selected from 11 emergency obstetric care facilities and medical records reviewed by trained obstetricians.

RESULT: Of 91 cases (Benin, 28; Ecuador, 25; Jamaica, 38), 74% were correctly treated with anticonvulsant and 77% with antihypertensive therapy. The median interval to treat eclampsia (anticonvulsant, 28 min; antihypertensive, 77 min) was shorter than for severe pre-eclampsia (anticonvulsant, 45 min; antihypertensive, 85 min). Two in three cases (65%) received anticonvulsant but only 41% received antihypertensive therapy within 60 min of diagnosis. While 74% of eclamptics had been delivered within 12 h, only 39% of severe pre-eclamptics were delivered within 24 h.

CONCLUSION

Timeliness can be studied in developing countries. Its objective measurement is a first step towards improving this component of care.