[TOLUCA experience in preeclampsia-eclampsia].

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Public Health

Background:

• Preeclampsia-eclampsia presents a significant challenge in reducing maternal morbidity and mortality.
• A dedicated research unit and expert committee were established in Toluca, Mexico, in 1997.
• An educational program and a specific diagnosis and treatment protocol (TOLUCA) were developed.

Purpose of the Study:

• To evaluate the impact of the TOLUCA protocol on maternal mortality.
• To assess the influence of an educational program and research unit on patient outcomes.
• To determine the effectiveness of a standardized approach to managing preeclampsia-eclampsia.

Main Methods:

• A retrospective review of maternal mortality data in an obstetric intensive care unit was conducted.
• Data were analyzed for periods before (1992-1996) and after (1997-2003) the implementation of the TOLUCA protocol.
• The impact of human resources from educational programs and research initiatives was also reviewed.

Main Results:

• Maternal mortality decreased from 13.4% (1 in 7 admissions) before the protocol to 4.3% (1 in 23 admissions) after its implementation.
• Over 12 years, 1723 patients were treated, with preeclampsia-eclampsia being the leading cause of maternal death (48%).
• The study period saw the publication of 25 research papers, four books, and six book chapters, alongside the establishment of a research unit.

Conclusions:

• The TOLUCA protocol demonstrates effectiveness in improving medical care for preeclampsia-eclampsia.
• The protocol can serve as a prototype for obstetric-gynecology hospitals aiming to enhance patient outcomes.
• Integration of high-level care with ongoing research is crucial for advancing obstetric medicine.