Preeclampsia is a relatively frequent condition during pregnancy and childbirth. The administration of magnesium sulphate as a prophylactic and treatment measure is an evidence-based practice for eclampsia; however, it is not consistently used, compromising the health of pregnant women. This study aimed to assess compliance with recommendations of the International Society for the Study of Hypertension in Pregnancy (ISSHP) for the use of MgSO4 in pregnant women with preeclampsia, before and after the implementation of the World Health Organization Safe Childbirth Checklist (SCC). This quasi-experimental study was conducted between July 2015 and July 2016 at a third-level maternity hospital in northeastern Brazil, where the SCC was implemented. Compliance (underuse and overuse of MgSO4) was assessed in biweekly samples of 30 deliveries assessed 6 months before and 6 months after SCC implementation, using indicators based on international guidelines. A total of 720 deliveries were assessed over 1 year using an ad hoc application for reviewing medical records. Aggregated adequate use was estimated for the study period, and the time series measurements were compared to a control chart to assess change. The incidence of preeclampsia was 39.9% (287/720). Among these, 64.8% (186/287) had severe signs or symptoms and needed MgSO4. Underuse (no prescription when needed) of MgSO4 was observed in 74.7% (139/186) of women who needed the drug. Considering all women, non-compliance with the prescription protocol (underuse and overuse) was 20.0% (144/720). After introducing the SCC, the use of MgSO4 in women with preeclampsia with severe features increased from 19.1 to 34.2% (p = 0.025). Longitudinal analysis showed a significant (p < 0.05) ascending curve of adequate use of MgSO4 after the SCC was implemented. Compliance with recommendations for the use of MgSO4 in preeclampsia was low, but improved after implementation of the SCC. Interventions to improve compliance based on diagnosis and treatment reminders may help in the implementation of this good practice.

中文翻译：

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世卫组织安全分娩检查表的实施：通过为期一年的纵向研究对硫酸镁处方的影响

子痫前期在妊娠和分娩期间是相对频繁的状况。给予硫酸镁作为预防和治疗措施是子痫的循证实践。然而，它并没有被一贯使用，损害了孕妇的健康。这项研究旨在评估在实施世界卫生组织安全分娩检查表（SCC）之前和之后，国际妊娠高血压研究协会（ISSHP）对先兆子痫孕妇使用MgSO4的建议的遵守情况。这项准实验研究于2015年7月至2016年7月在巴西东北部实施SCC的三级妇产医院进行。在SCC实施前6个月和6个月后的30个月中，每两周进行一次评估，评估其依从性（未充分使用和过度使用MgSO4），使用的指标基于国际准则。使用临时应用程序检查病历在一年内共评估了720例分娩。估算了研究期间的合计充分使用量，并将时间序列测量值与对照图进行比较以评估变化。子痫前期的发生率为39.9％（287/720）。其中64.8％（186/287）有严重的体征或症状，需要使用MgSO4。在需要药物的女性中，有74.7％（139/186）的患者使用了MgSO4不足（不需要处方）。考虑到所有妇女，不遵守处方规程（使用不足和过度使用）为20.0％（144/720）。引入SCC之后，具有严重特征的先兆子痫女性中使用MgSO4的比例从19.1％增加到34.2％（p = 0.025）。纵向分析显示，在实施SCC后，适当使用MgSO4的显着（p <0.05）上升曲线。对先兆子痫中使用MgSO4的建议的依从性较低，但在实施SCC后有所改善。基于诊断和治疗提示来提高依从性的干预措施可能有助于实施这种良好做法。