{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:36:18Z","timestamp":1780497378278,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001504","name":"Ministry of Health, New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001504","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pre\u2010eclampsia and related sequelae are a leading cause of severe maternal and neonatal morbidity and mortality. A significant proportion of these poor outcomes may be preventable with improvements along the continuum of maternal and neonatal care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to review cases of pre\u2010eclampsia resulting in severe maternal morbidity, describing the maternal and neonatal outcomes and the potential preventability of severe maternal morbidity (SMM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This was a retrospective cohort study of cases of <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content> associated with severe pre\u2010eclampsia \u2013 a subset of a national <jats:styled-content style=\"fixed-case\">SMM<\/jats:styled-content> review study. Inclusion criteria for this subset were women who were pregnant or within 42\u00a0days of delivery with severe pre\u2010eclampsia as the main reason for admission to an intensive care unit or high dependency unit in New Zealand between 1 August 2013 and 31 January 2015 inclusive. A multidisciplinary expert panel reviewed cases for preventability using a validated preventability tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 89 severe morbidities that were reviewed, 10 had eclampsia (11%) and there were four neonatal mortalities (4.3%). Multidisciplinary committees assessed the severe morbidity as potentially preventable in 31% (28) of cases with the majority due to delays in diagnosis and suboptimal treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found a high level of preventable morbidity in cases of severe pre\u2010eclampsia with a concerning number of preventable eclampsia. Implementation of evidence\u2010based guidelines reinforced with education would assist clinicians to improve risk recognition, timely diagnosis and treatment and decrease potentially preventable severe morbidity associated with pre\u2010eclampsia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12971","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T08:18:31Z","timestamp":1552983511000},"page":"825-830","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Pre\u2010eclampsia causing severe maternal morbidity \u2013 A national retrospective review of preventability and opportunities for improved care"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9307-2323","authenticated-orcid":false,"given":"Evelyn Jane","family":"MacDonald","sequence":"first","affiliation":[{"name":"Women's Health Research Centre Faculty of Health Victoria University of Wellington  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Lepine","sequence":"additional","affiliation":[{"name":"Wellington Regional Hospital  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Pledger","sequence":"additional","affiliation":[{"name":"Health Services Research Centre Faculty of Health Victoria University of Wellington  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacie E.","family":"Geller","sequence":"additional","affiliation":[{"name":"Centre for Research on Women and Gender University of Illinois  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bev","family":"Lawton","sequence":"additional","affiliation":[{"name":"Women's Health Research Centre Faculty of Health Victoria University of Wellington  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60279-6"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12399"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30184-8"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.07.010"},{"key":"e_1_2_6_7_1","volume-title":"Maternity Clinical Indicators 2015","author":"Ministry of Health","year":"2016"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04850"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.02.026"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60136-1"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000397"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13526"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2016.03.034"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12787"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12454"},{"key":"e_1_2_6_16_1","volume-title":"Report on Maternity 2014","author":"Ministry of Health","year":"2015"},{"key":"e_1_2_6_17_1","volume-title":"Guidelines for Consultation with Obstetric and Related Medical Services (Referral Guidelines)","author":"Ministry of Health","year":"2012"},{"key":"e_1_2_6_18_1","unstructured":"New Zealand Ministry of Health.National Health Index 2012. 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