PubMed · 13519056
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W J HOOTSMANS, J A VAN PROOIJE. 1957. [The eclampsia problem].. https://pubmed.ncbi.nlm.nih.gov/13519056/
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PROBLEM: Infrequent presentation of patients with eclampsia, leading to staff inexperienced in the condition and untested emergency systems. DESIGN: "Fire drill" programme using on-site simulation of patients with eclampsia. SETTING: Tertiary referral obstetric unit. KEY MEASURES FOR IMPROVEMENT: Successful implementation of measures to optimise management of eclampsia. STRATEGIES FOR CHANGE: Rapid activation of emergency team after one call, development and dissemination of evidence based protocol for eclampsia, strategically placed "eclampsia boxes," individual staff feedback and education. EFFECTS OF CHANGE: Efficient and appropriate management of subsequent simulated patients. LESSONS LEARNT: On-site simulation can identify and correct potential deficiencies in the care of patients with eclampsia.
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Hypertensive disorders during pregnancy, which account for approximately 15% of pregnancy-related deaths, represent the second-leading cause of morbidity and mortality in the United States. New classifications recommended by the National Institutes of Health's Working Group on High Blood Pressure in Pregnancy have decreased the confusion often associated with these disorders. The cause of preeclampsia-eclampsia still remains elusive, but continued research has provided hope with regard to screening, improved diagnosis, and management. Risk factors that have recently gained attention include inherited thrombophilias, inherited metabolic disorders, and lipid disorders. Treatment and management of the hypertensive disorders of pregnancy have not changed substantially in the past 50 years. Prevention of preeclampsia-eclampsia has been unsuccessful, and recurrence risks remain high. Careful diagnosis, classification, and further investigation of the causes of hypertensive disorders in pregnancy are needed to achieve optimal management of affected women and their fetuses.