Management of Severe Pre-eclampsia within 24hours Postpartum at a Tertiary Hospital in Lusaka, Zambia: A clinical Audit

The worldwide incidence of pre-eclampsia ranges between 2% and 5%. Due to its complications, preeclampsia remains a significant public health threat,especially in developing countries. The quality of care given to postpartum women with severe preeclampsia has implications on disease progression.We audited the immediate postpartum care given to women with severe pre-eclampsia at the Women and Newborn Hospital-University Teaching Hospitals, atertiary level hospital in Lusaka, Zambia. We retrospectively reviewed 170 patient's medical records for the period of January 2020 to July 2020 and audited their management based on the local standard guidelines for the management of severe pre-eclampsia. The total number of patients seen during the study period was 1,317. Of these, the total number with SPE was 170, giving a period prevalence of 12%. Allpatients were admitted to the Special observation unit, now Obstetrics intensive care unit (OICU). 12 SPE patient files had incomplete data; hence their information was not included in the analysis to maintain data quality. All 158 patients received antihypertensive drugs, MgSO₄, with only 35% having laboratory results available.We found that more than 85% of women received adequate care according to standard guidelines on most parameters, including magnesium sulphate administration; however, the laboratory tests were below standard as only 36% of these women had adequate investigations. These findings arepromising, indicating that high quality care is achievable in a low resource setting through clinical audits and completing the audit cycles with a focus on correcting identified gaps.