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Introduction of management protocol for early‐onset severe pre‐eclampsia
Author(s) -
Sakae Chieko,
Sato Yukiyasu,
Kanbayashi Shota,
Taga Atsuko,
Emoto Ikuko,
Maruyama Shunsuke,
Mise Hiroko,
Kim Tomoko
Publication year - 2017
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13265
Subject(s) - medicine , eclampsia , protocol (science) , gestational age , pregnancy , obstetrics , proteinuria , pathology , genetics , alternative medicine , biology , kidney
Aim This quality Improvement study evaluated the applicability of our protocol for early‐onset severe pre‐eclampsia, prepared in April 2013. Methods We collected data from all women with early‐onset severe pre‐eclampsia treated at our hospital between March 2008 and August 2015. Neonatal and maternal outcomes were compared between protocol‐based ( n = 17) and non‐protocol‐based management groups ( n = 28). Results The latency period was significantly longer in the protocol‐based than in the non‐protocol‐based group (21.9 ± 3.7 vs 11.0 ± 2.9 days). Gestational age at delivery was significantly more advanced in the protocol‐based than in the non‐protocol‐based group (31.4 ± 0.6 vs 29.8 ± 0.4 weeks). Serious neonatal complications were significantly less prevalent in the protocol‐based than in the non‐protocol‐based group (26% vs 79%). Among the protocol components, magnesium sulfate use was the only independent factor contributing to the absence of serious neonatal complications. The percentages of women exhibiting persistent proteinuria or hypertension at one, two and three months post‐partum were similar between the groups. Conclusions Strict adherence to our protocol improved neonatal outcomes without affecting maternal prognosis. Routine use of magnesium sulfate could be the most important component of the protocol.