uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Criteria-based audit on management of eclampsia patients at a tertiary hospital in Dar es Salaam, Tanzania
Dept of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Dep of Clinical Science, Obstetrics and Gynaecology, Umeå University, Sweden.
Dept of Obstetrics and Gynaecology, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell kvinno- & mödrahälsovård/ Essén)
Show others and affiliations
2009 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, Vol. 9, 13Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Criteria-based audits have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the introduction of a criteria-based audit in a tertiary hospital in an African setting, assesses the quality of care among eclampsia patients and discusses possible interventions in order to improve the quality of care. METHODS: We conducted a criteria based audit of 389 eclampsia patients admitted to Muhimbili National Hospital (MNH), Dar es Salaam Tanzania between April 14, 2006 and December 31, 2006. Cases were assessed using evidence-based criteria for appropriate care. RESULTS: Antepartum, intrapartum and postpartum eclampsia constituted 47%, 41% and 12% of the eclampsia cases respectively. Antepartum eclampsia was mostly (73%) preterm whereas the majority (71%) of postpartum eclampsia cases ware at term. The case fatality rate for eclampsia was 7.7%. Medical histories were incomplete, the majority (75%) of management plans were not reviewed by specialists in obstetrics, specialist doctors live far from the hospital and do not spend nights in hospital even when they are on duty, monitoring of patients on magnesium sulphate was inadequate, and important biochemical tests were not routinely done. Two thirds of the patient scheduled for caesarean section did not undergo surgery within agreed time. CONCLUSION: Potential areas for further improvement in quality of emergency care for eclampsia relate to standardizing management guidelines, greater involvement of specialists in the management of eclampsia and continued medical education on current management of eclampsia for junior staff.

Place, publisher, year, edition, pages
2009. Vol. 9, 13
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:uu:diva-107816DOI: 10.1186/1471-2393-9-13ISI: 000208106900013PubMedID: 19323846OAI: oai:DiVA.org:uu-107816DiVA: diva2:233235
Available from: 2009-08-31 Created: 2009-08-31 Last updated: 2015-08-14Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Lindmark, Gunilla
By organisation
Department of Women's and Children's Health
In the same journal
BMC Pregnancy and Childbirth
Obstetrics, Gynecology and Reproductive MedicinePublic Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 214 hits
ReferencesLink to record
Permanent link

Direct link