{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:46:39Z","timestamp":1792244799321,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["320181"],"award-info":[{"award-number":["320181"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The World Health Organization recommends surveillance, including audits with case reviews of severe maternal morbidities such as eclampsia, to improve obstetric outcomes. We aimed to audit eclampsia and to identify learning opportunities in eclampsia care in Norway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Our study population included all women discharged with a diagnosis of eclampsia (ICD\u201010: O15) and with a documented generalized seizure in medical records at two university hospitals in Norway from 2013 to 2022. An eclampsia working group developed a digital eclampsia case report form for gathering clinical information from medical records. Based on a structured summary of information from the digital case report form, the group reviewed the care for women with eclampsia. Each case was discussed and reviewed according to the clinical guidelines by the group. Learning opportunities to improve care were identified and classified according to whether they contributed to the outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 93\u2009139 deliveries, 22 women with an initial eclampsia diagnosis were identified (2.4 per 10\u2009000). Subsequent clinical information identified an alternative probable etiology of seizures in five women. None of the 22 women received magnesium sulfate prior to the seizure, and cerebral imaging was performed in 11 of 22 women. In 18 women, learning opportunities were identified, and for eight women, a different management could potentially have prevented eclampsia. The eclampsia working group identified learning opportunities related to underuse of magnesium sulfate prophylaxis when indicated, inadequate management of hypertension both before and after eclamptic seizure, underuse of cerebral imaging as a diagnostic tool, and lack of follow\u2010up consultation with an obstetrician in women diagnosed with eclampsia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Learning opportunities were found in 18 of 22 women, and improvements in care could potentially have changed the outcome for eight of the women. This audit highlights the importance of differential diagnostic consideration for seizures in pregnant and postpartum women, the use of prophylactic magnesium sulfate when indicated, and the diagnosis and management of hypertension in pregnancy. Eclampsia audits should be incorporated into national routine surveillance and learning systems to improve obstetric care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70280","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:47:06Z","timestamp":1781689626000},"page":"1767-1777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Learning opportunities in eclampsia care: A ten\u2010year audit from Norway, 2013\u20132022"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1437-2660","authenticated-orcid":false,"given":"Camilla Tj\u00f8nneland","family":"Mentzoni","sequence":"first","affiliation":[{"name":"Division of Public Health and Prevention Norwegian Institute of Public Health  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8380-0151","authenticated-orcid":false,"given":"Kjerstine","family":"R\u00f8e","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care University of Bergen  Bergen Norway"},{"name":"Department of Obstetrics and Gynecology Stavanger University Hospital  Stavanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solveig","family":"Bjellmo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology M\u00f8re og Romsdal Hospital Trust  Aalesund Norway"},{"name":"Department of Health Science Norwegian University of Science and Technology  Aalesund Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marte Irene Skille","family":"Carlsen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine St Olav's University Hospital  Trondheim Norway"},{"name":"Department of Circulation and Medical Imaging Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marit Halonen","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Stavanger University Hospital  Stavanger Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tora Sandvik","family":"Fjeldstad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Henriksen","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Truc Trung","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Public Health and Prevention Norwegian Institute of Public Health  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8120-6825","authenticated-orcid":false,"given":"Lill Trine","family":"Nyfl\u00f8t","sequence":"additional","affiliation":[{"name":"Norwegian Research Center for Women's Health Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leiv Arne","family":"Rosseland","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical Care, Department of Research and Development Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oddvar","family":"Uleberg","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Department of Emergency Medicine and Prehospital Services St Olav's University Hospital  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4681-4774","authenticated-orcid":false,"given":"Siri","family":"Vangen","sequence":"additional","affiliation":[{"name":"Norwegian Research Center for Women's Health Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Klungs\u00f8yr","sequence":"additional","affiliation":[{"name":"Division of Public Health and Prevention Norwegian Institute of Public Health  Bergen Norway"},{"name":"Department of Global Public Health and Primary Care University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1582-4283","authenticated-orcid":false,"given":"Hilde Marie","family":"Engjom","sequence":"additional","affiliation":[{"name":"Division of Public Health and Prevention Norwegian Institute of Public Health  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"OCINOR\u2014Eclampsia Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_14_2_1","volume-title":"Evaluating the Quality of Care for Severe Pregnancy Complications: the WHO Near\u2010Miss Approach for Maternal Health","author":"World Health O","year":"2011"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-018-0527-2"},{"key":"e_1_2_14_4_1","volume-title":"Hvorfor d\u00f8r kvinner av graviditet i Norge i dag ? Rapport maternelle d\u00f8dsfall 2012\u20132018 (Norwegian)","author":"Nyfl\u00f8t L","year":"2021"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03330.x"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12802"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12868"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(12)39601-8"},{"key":"e_1_2_14_9_1","unstructured":"Hypertensive pregnancy complications and eclampsia \u2010 Guideline for obstetric care 2020 by the Norwegian Society of Gynecology and Obstetrics. Accessed October 31 2025.https:\/\/metodebok.no\/emne\/K4U6nNQ3\/hypertensive\u2010svangerskapskomplikasjoner\u2010og\u2010eklampsi\u2010(2020)\/f%C3%B8dselshjelp\u2010(ngf)"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08778-0"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13493"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340600607149"},{"key":"e_1_2_14_13_1","unstructured":"Medical Birth Registry of Norway\u2014statistics. Accessed December 15 2025.https:\/\/statistikk.fhi.no\/mfr\/Kg8Qeund8\u2010FnrmTJlQhiN0L1Mr68O258kCXKMUx5y4k"},{"key":"e_1_2_14_14_1","unstructured":"Hypertensive pregnancy complications and eclampsia\u2014Guideline for obstetric care 2014 by the Norwegian Society of Gynecology and Obstetrics. Accessed October 31 2025.https:\/\/legeforeningen.no\/foreningsledd\/fagmed\/norsk\u2010gynekologisk\u2010forening\/veiledere\/arkiv\u2010utgatte\u2010veiledere\/veileder\u2010i\u2010fodselshjelp\u20102014\/28.\u2010hypertensive\u2010svangerskapskomplikasjoner\u2010og\u2010eklampsi\u2010pasientinformasjon\u20102016"},{"key":"e_1_2_14_15_1","volume-title":"Hypertensive Pregnancy Complications \u2010 Guideline for Obstetric Care 2008 by the Norwegian Society of Gynecology and Obstetrics","author":"Lorentzen B","year":"2008"},{"key":"e_1_2_14_16_1","unstructured":"UKOSS Eclampsia Study 04\/05 Data Collection Form. Accessed November 7 2025.https:\/\/www.npeu.ox.ac.uk\/assets\/downloads\/ukoss\/forms\/UKOSS\u2010Eclampsia.pdf"},{"key":"e_1_2_14_17_1","unstructured":"The Confidential Enquiry into Maternal Morbidity. Accessed December 15 2025.https:\/\/www.npeu.ox.ac.uk\/mbrrace\u2010uk\/maternal\u2010programme\/maternal\u2010confidential\u2010enquiries#the\u2010confidential\u2010enquiry\u2010into\u2010maternal\u2010morbidity"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)90226-7"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0301976"},{"key":"e_1_2_14_20_1","doi-asserted-by":"crossref","unstructured":"Oppf\u00f8lging etter hjemkomst (Norwegian). Accessed January 27 2026.https:\/\/www.helsenorge.no\/etter\u2010fodsel\/oppfolging\u2010etter\u2010hjemkomst\/","DOI":"10.1063\/pt.2be557b9c8"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13357"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.07.010"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.12.057"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1331026"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12510"},{"key":"e_1_2_14_26_1","unstructured":"FelkerA PatelR KotnisR KenyonS KnightM.Saving lives improving Mothers' Care: lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2021\u201323. In:FelkerA PatelR KotnisR KenyonS KnightM eds.National Perinatal Epidemiology Unit University of Oxford;2025."},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003037"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.4426"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002364"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2020.05.022"},{"key":"e_1_2_14_31_1","unstructured":"NorwitzER MarshallN SchachterSC EcklerK.Eclampsia. 4. aug 2025 ed. UpToDate.2025."},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2013.04.001"},{"key":"e_1_2_14_33_1","volume-title":"Veileder i Akuttnevrologi","author":"Norsk Nevrologisk Forening","year":"2022"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2008.04.010"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2024.101184"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.10.034"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753495X221150302"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.02.008"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2016.06.010"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/1177083X.2018.1528990"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12454"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70280","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70280","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T06:05:42Z","timestamp":1786169142000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":40,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/aogs.70280"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70280","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"assertion":[{"value":"2026-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}