Mortality cases that occurred in the Netherlands between
2000 and 2004 were assessed in the study 15. The standard of
quality of care had presupposed the guidelines of the Dutch
Society of Obstetrics and Gynecology. Of the 135 cases of
deaths, 27 (20%) women died as a result of hypertensive disorders.
All women met the criteria for the diagnosis of preeclampsia,
of which 16 (60%) resulted in eclampsia. In 60% of
cases, prenatal care was performed by traditional midwives, and
96% compliance was considered low-level or below required.
As low quality examples, the authors cited late onset of prenatal
care and lack of BP check in the first quarter. In 46% of
cases, laboratory tests were not carried out for the detection of
proteinuria, and in all of them, the risk factors for pre-eclampsia
were present during pregnancy. There was delay in referral
to treatment (15%) and in hospital care, 41% did not make
the relevant diagnostic tests, 85% had inadequately hypertension
and 74% were misdiagnosis of mild pre-eclampsia when,
in fact, they would be classified as severe cases. It was found
that the low quality of care was present in almost all cases of
maternal death resulting from hypertensive disorders(27)