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Development and Use of Quality of Care Indicators for Obstetric Care in Women with Preeclampsia, Severe Preeclampsia, and Severe Morbidity

Objective: To develop indicators for evaluating the quality of care in managing preeclampsia. Methods: An expert group helped to develop and validate the following indicators for evaluating quality of care: availability of intensive care; completeness of laboratory tests; appropriateness of drug treatment at admission and before delivery (antihypertensive drugs, anticonvulsants, and dexamethasone); gestational age at which pregnancy should be interrupted; and type of delivery. By using these indicators, it was possible to evaluate the quality of care in 432 patients with preeclampsia. Results: A significant percentage of patients with preeclampsia and “near misses” received low quality of care, regardless of disease severity. Conclusion: A number of interventions are needed to increase the quality of care to help avert maternal deaths in patients with preeclampsia.