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

Objective: Cases meeting diagnostic criteria for severe pre-eclampsia or ectampsia 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 anti hypertensive therapy. The median interval to treat ectampsia (anticonvulsant, 28 min; anti hypertensive, 77 min) was shorter than for severe pre-eclampsia (anticonvulsant, 45 min; anti hypertensive, 85 min). Two in three cases (65%) received anticonvulsant but only 41% received anti hypertensive therapy within 60 min of diagnosis. While 74% of ectamptics 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. (c) 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.