Magnesium sulfate for eclampsia prevention: Quality of care evaluation in a tertiary centre in Québec, Canada

Girard, Pascale; Quirion, Alexandre; Bureau, Yves-André; Sauvé, Nadine

doi:10.1177/1753495x13518319

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…The adherence rate for time of MgSO4 use was 20.79%. Similar findings have been previously reported [12,13]. However, Shields et al showed that high levels of compliance can be achieved in a relatively short period of time [16].…”

Section: Discussionsupporting

confidence: 90%

“…Previous studies evaluating drug therapy guideline adherence for HDPs have mainly focused on the time of drug use [11][12][13], and guideline adherence regarding the route of administration and drug dosage is unknown, especially in China. The associations between drug therapy guideline adherence for HDPs and recommendation evidence are also unclear.…”

Section: Introductionmentioning

confidence: 99%

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Adherence to drug therapy for hypertensive disorders of pregnancy: a cross-sectional survey

et al. 2020

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Background: Hypertensive disorders of pregnancy (HDPs) are a major contributor to maternal mortality worldwide, and drug therapy for HDPs is complicated and special. Clinical guidelines help physicians optimize the care for HDPs, but little is known about whether physicians adhere to drug therapy guidelins well, especially in China. This study aims to evaluate adherence to the drug therapy guidelines of the Chinese Obstetricians and Gynecologists Association (COGA) for HDPs and to explore the corresponding associations with recommendation evidence. Methods: A cross-sectional design was executed for 306 women with HDPs hospitalized in a maternity ward of a tertiary hospital from August 2014 to July 2015 in Hubei, China. Adherence to the COGA guidelines was evaluated according to six items: the time of use and route of administration and dosage of antihypertensive drugs, MgSO 4 , and corticosteroids. Binary logistic regression was adopted to explore the associations between adherence to clinical decisions and recommendation evidence. Results: The average adherence rate for drug therapy for HDPs was 48.22%. The adherence rate for the time of antihypertensive drug and corticosteroid use scored 95.65 and 86.75%, whereas the other four items of the time of MgSO 4 use and the routes of administration and dosages of antihypertensive drugs, MgSO 4 , and corticosteroids scored < 50.00%. High-and low-evidence-based recommendations were followed in 40.00 and 54.70% of the decisions, respectively. Logistic regression revealed that recommendation evidence (OR = 0.588, P = 0.003) was associated with adherence. Conclusions: Further improvement is still needed to achieve good adherence, especially regarding the time of MgSO 4 use and drug dosage. High-evidence-based management of drug therapy for HDPs should be strengthened.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Adherence to drug therapy for hypertensive disorders of pregnancy: a cross-sectional survey

et al. 2020

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“…Underutilization of magnesium sulphate among women with ‘severe’ pre-eclampsia is consistent with other studies, whether they be single-centre studies in Canada [ 16 ] or multicentre international studies [ 12 ]. Variation in opinion about what constitutes ‘severe’ pre-eclampsia is reflected in between-protocol variation in 22 Canadian tertiary hospitals and within-hospital differences in protocol and practice [ 17 ].…”

Section: Discussionsupporting

confidence: 89%

Determinants of magnesium sulphate use in women hospitalized at <29 weeks with severe or non-severe pre-eclampsia

et al. 2017

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ObjectiveMagnesium sulphate is recommended by international guidelines to prevent eclampsia among women with pre-eclampsia, especially when it is severe, but fewer than 70% of such women receive magnesium sulphate. We aimed to identify variables that prompt Canadian physicians to administer magnesium sulphate to women with pre-eclampsia.MethodsData were used from the Canadian Perinatal Network (2005–11) of women hospitalized at <29 weeks’ who were thought to be at high risk of delivery due to pre-eclampsia (using broad Canadian definition). Unadjusted analyses of relative risks were estimated directly and population attributable risk percent (PAR%) calculated to identify variables associated with magnesium sulphate use. A multivariable model was created and a generalized estimating equation was used to estimate the adjusted RR that explained magnesium sulphate use in pre-eclampsia. The adjusted PAR% was estimated by bootstrapping.ResultsOf 631 women with pre-eclampsia, 174 (30.1%) had severe pre-eclampsia, of whom 131 (75.3%) received magnesium sulphate. 457 (69.9%) women had non-severe pre-eclamspia, of whom 291 (63.7%) received magnesium sulphate. Use of magnesium sulphate among women with pre-eclampsia could be attributed to the following clinical factors (PAR%): delivery for ‘adverse conditions’ (48.7%), severe hypertension (21.9%), receipt of antenatal corticosteroids (20.0%), maternal transport prior to delivery (9.9%), heavy proteinuria (7.8%), and interventionist care (3.4%).ConclusionsClinicians are more likely to administer magnesium sulphate for eclampsia prophylaxis in the presence of more severe maternal clinical features, in addition to concomitant antenatal corticosteroid administration, and shorter admission to delivery periods related to transport from another institution or plans for interventionist care.

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Magnesium sulfate for eclampsia prevention: Quality of care evaluation in a tertiary centre in Québec, Canada

Cited by 2 publications

References 16 publications

Adherence to drug therapy for hypertensive disorders of pregnancy: a cross-sectional survey

Adherence to drug therapy for hypertensive disorders of pregnancy: a cross-sectional survey

Determinants of magnesium sulphate use in women hospitalized at <29 weeks with severe or non-severe pre-eclampsia

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