Evidence map›Paper›PMID 28867883›Full record

ArticleJournal of obstetrics and gynaecology of India2017

Examining the Use of Magnesium Sulfate to Treat Pregnant Women with Preeclampsia and Eclampsia: Results of a Program Assessment of Emergency Obstetric Care (EmOC) Training in India.

Henna Budhwani, Poonam Shivkumar, Chittaranjan Narhari Purandare, Nicholas A Cataldo, Sadhana Desai, Prakash Bhatt, Dinesh Baswal, Ajey Bhardwaj

Abstract read
In one paragraph

Article in Journal of obstetrics and gynaecology of India, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Henna BudhwaniSchool of Public Health, University of Alabama at Birmingham (UAB), 517D Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL 35294 USA.
Poonam ShivkumarMahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, 442102 India.
Chittaranjan Narhari PurandareInternational Federation of Gynecology and Obstetrics, FIGO House, London, SE1 8ST UK.
Nicholas A CataldoSchool of Public Health, University of Alabama at Birmingham (UAB), 517D Ryals Public Health Building, 1665 University Boulevard, Birmingham, AL 35294 USA.
Sadhana DesaiFederation of Obstetric and Gynaecological Societies of India, Mumbai, 400013 India.
Prakash BhattFederation of Obstetric and Gynaecological Societies of India, Mumbai, 400013 India.
Dinesh BaswalMinistry of Health and Family Welfare, Government of India, New Delhi, 110011 India.
Ajey BhardwajAvni Health Foundation, 101 Prangan Coop. Hsg, 15 Malviya Road, Vile Parle East, Mumbai, 400057 India.
University of Alabama at Birmingham · USGovernment of India · INInternational Federation of Gynaecology and Obstetrics · GBMahatma Gandhi Institute of Medical Sciences · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this study is to examine rates of magnesium sulfate utilization by emergency obstetric care trainees to treat preeclampsia-eclampsia in India. Secondarily, structural barriers are identified which limit the use of magnesium sulfate, highlighting limitations of emergency obstetric care training, which is a commonly implemented intervention in resource-poor settings.

methodsTrainees' curriculum specified magnesium sulfate treatment for eclampsia and severe preeclampsia. Case records were analyzed for preeclampsia-eclampsia diagnosis, magnesium sulfate utilization, delivery route, and maternal and neonatal outcomes from 13,238 reported deliveries between 2006 and 2012 across 75 district hospitals in 12 Indian states.

resultsOf 1320 cases of preeclampsia-eclampsia, 322 (24.4%) had eclampsia. Magnesium sulfate was given to 12.9% of preeclamptic and 54.3% of eclamptic women, with lower usage rates in rural communities. Among the 1308 women with preeclampsia-eclampsia, only 24 deaths occurred (1.8%). In contrast, among the 17,179 women without preeclampsia-eclampsia, there were 95 reported deaths (0.6%). Both maternal mortality ratios were found to be much higher than the Millennium Development Goal target of 0.15%. Magnesium sulfate administration was associated with a higher death rate in preeclamptic but not eclamptic women, representing possible confounding by severity.

conclusionTo optimize resources spent on emergency obstetric care training, the consistent availability of magnesium sulfate should be improved in India. Increasing drug availability, implementing clinical guidelines around its administration, and training health-care providers on the identification and treatment of preeclampsia-eclampsia could lead to notable improvements in maternal and infant mortality.

Indexed as

EclampsiaEmergency obstetric careIndiaMagnesiumMaternal mortality

Identifiers

PMID28867883
PMCPMC5561760
OpenAlexW2586084531

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.