Factors influencing pre-eclampsia / eclampsia outcomes in high-risk patients in Zimbabwe: research

  • C Mudokwenuy-Rawdon
  • M.C. Bezuidenhout

Abstract

Severe pre-eclampsia / eclampsia remains one of the major causes of maternal mortality in Zimbabwe. Based on this problem, factors associated with maternal mortality due to severe pre-eclampsia / eclampsia were investigated in an effort to improve pregnancy outcomes in Zimbabwe. Cases and controls were selected from 318 obstetric records of patients with severe pre-eclampsia / eclampsia to conduct a retrospective case-control study. (Cases referred to patients who were diagnosed with severe pre-eclampsia / eclampsia and who died from these conditions while controls survived these conditions). No significant factors could be identified which influenced maternal deaths among women suffering from severe pre-eclampsia / eclampsia. Magnesium sulphate was not routinely administered, as recommended internationally. Cases apparently received better reported care than controls. Recommendations based on this research report include improved midwifery education and in-service training, regular audits of patients' records and changed policies for managing these conditions more effectively in Zimbabwe.

Ernstige pre-eklampsie / eklampsie bly een van die hoofoorsake van moederlike sterftes in Zimbabwe. Gebaseer op die probleem is faktore wat verband hou met moederlike sterftes as gevolg van ernstige pre-eklampsie / eklampsie ondersoek, in 'n poging om die swangerskapsuitkomstes in Zimbabwe te verbeter. Gevalle en kontroles is geselekteer uit 318 ernstige pre-eklampsie / eklampsie obstetriese rekords ten einde 'n retrospektiewe gevallekontrolestudie uit te voer. Geen beduidende faktore was identifiseerbaar wat moederlike sterftes onder vrouens met ernstige pre-eklampsie / eklampsie beïnvloed het nie. Magnesiumsulfaat was nie as roetine, teenstrydig met internasionale aanbevelings, toegedien nie. Volgens verslae het gevalle klaarblyklik beter sorg gekry as kontroles. (Gevalle is gedefinieer as pasiënte wat met pre-eklampsie / eklampsie gediagnoseer was en daaraan beswyk het terwyl kontroles die toestande oorleef het). Aanbevelings wat op die navorsingsverslag gegrond is, sluit in dat vroedvroue se onderrig en indiensopleiding verbeter moet word, pasiënte se rekords aan gereelde ouditering onderwerp moet word, en dat beleid verander moet word om die toestande in Zimbabwe meer effektief te beheer.

Key words: Case fatality rate, Maternal mortality ratio, Quality care, Risk factor, Severe pre-eclampsia eclampsia

(Health SA Gesondheid : interdisciplinary research journal: 2003 8(1): 39-56)
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eISSN: 2071-9736
print ISSN: 1025-9848