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Use of magnesium sulfate for treatment of pre‐eclampsia and eclampsia in Mexico
Author(s) -
van Dijk Marieke G.,
Díaz Olavarrieta Claudia,
Zuñiga Patricia Uribe,
Gordillo Rufino Luna,
Gutiérrez MariaElena Reyes,
García Sandra G.
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.11.015
Subject(s) - eclampsia , medicine , magnesium , obstetrics , pregnancy , metallurgy , genetics , materials science , biology
Objective To establish a baseline of magnesium sulfate utilization prior to publication of the updated 2006 technical guidelines on pre‐eclampsia and eclampsia in Mexico, and to examine barriers to treating pregnant women with magnesium sulfate as perceived by maternal health experts. Methods In collaboration with the Federal Ministry of Health, medical charts were reviewed for 87 maternal deaths due to hypertensive disorders that occurred in Mexico in 2005. Evidence was gathered on whether magnesium sulfate had been indicated or administered. In‐depth interviews with experts were conducted to identify barriers to treatment utilization. Results Magnesium sulfate had been used in 37.5% of severe pre‐eclampsia and 47.7% of eclampsia cases. Thematic analysis of expert interview data revealed 4 primary barriers to the implementation of evidence‐based guidelines and use of magnesium sulfate: lack of knowledge of magnesium sulfate, lack of acceptance, drug‐related barriers, and insufficient monitoring or supervision. It was found that magnesium sulfate was not the treatment used for Mexican women who died of pregnancy‐related hypertensive disorders in public facilities, and there was suboptimal implementation of evidence‐based practices and official guidelines. Conclusion The results highlight barriers to magnesium sulfate use, which constitutes a significant gap in treating women with eclampsia in Mexico.