Journal Critical Appraisal

Pre-eclampsia and eclampsia: An Update on the Pharmacological

Treatment Applied in Portugal

Disusun oleh:
Catherine Ienawi, S.Ked 04054821820033
Elfandari Taradipa, S.Ked 04054821820098
Ezra Hans Soputra, S.Ked 04054821820094
Mutia Mustika Sari, S.Ked 04054821820097
Nur Ilmi Sofiah, S.Ked 04054821820039
Siti Hanifahfuri S, S.Ked 04054821820096

Pembimbing:
dr.Bertha Octarina, Sp.OG

BAGIAN/ DEPARTEMEN OBSTETRI DAN GINEKOLOGI

RUMAH SAKIT DR. MOHAMMAD HOESIN PALEMBANG
FAKULTAS KEDOKTERAN UNIVERSITAS SRIWIJAYA
2019
 HALAMAN PENGESAHAN

Telaah Jurnal

Pre-eclampsia and eclampsia: An Update on the Pharmacological

Treatment Applied in Portugal

Oleh:

Catherine Ienawi, S.Ked 04054821820033

Elfandari Taradipa 04054821820098
Ezra Hans Soputra, S.Ked 04054821820094
Mutia Mustika Sari, S.Ked 04054821820097
Nur Ilmi Sofiah, S.Ked 04054821820039
Siti Hanifahfuri S, S.Ked 04054821820096

Telah diterima sebagai salah satu syarat dalam mengikuti Kepaniteraan Klinik
di Departemen Ilmu Kebidanan dan Penyakit Kandungan Fakultas Kedokteran
Universitas Sriwijaya RSUD Moh. Rabain Muara Enim periode 4 Februari - 15 April
2019.

Muara Enim, Maret 2019

dr.Bertha Octarina, Sp.OG

 JOURNAL CRITICAL APPRAISAL

The journal is accessed from the Journal of Cardiovascular Development and

Disease, which is part of evidence-based medicine and interpreted as a careful and
systematic evaluation process of a research article to determine its reliability, validity,
and usefulness in clinical practice. The level of trust in the results of a study is highly
dependent on research design where clinical trials rank highest. Critical review
includes all components of a study starting from the preliminary component,
methodology, results, and discussion. Each component has the same importance in
determining whether the results of the study are feasible or not used as a reference.

PICO VIA (Population, Intervention, Comparison, Outcome, Validity,

Importancy, Applicability)

1. Population
The researcher used literature in the form of articles available at PubMed
which contained information about pre-eclampsia, eclampsia, and pharmacological
therapy for pre-eclampsia and eclampsia. Those literature was collected from 2011-
2017. In addition to PubMed, several documents and guidelines available from
different hospitals and national and international organizations were also analyzed.

2. Intervention
The literature review begins by collecting pharmacological information about
pre-eclampsia and eclampsia from PubMed and also international guidelines. The
researcher then carried out an analysis of the guidelines and articles to describe the
most recommended pharmacological management for both hypertensive disorders in
pregnancy (pre-eclampsia and eclampsia).

3. Comparison
 The researcher conducted a literature analysis on the writings containing
information about pre-eclampsia, eclampsia, and pharmacological therapy of pre-
eclampsia and eclampsia originating from PubMed and the guidelines available from
hospitals / organizations based on several national and international provisions.

4. Outcome
In mild pre-eclampsia, slow release of nifedipine is the most recommended
drug, whereas labetalol is the drug of choice in severe pre-eclampsia. Magnesium
sulfate is used to avoid seizures due to eclampsia. Corticosteroids are used for fetal
lung maturation. Overall, avoidance of this disease is pharmacologically limited to
low-dose aspirin.

5. Study Validity

5.1 Is the focus of this research consistent with the research objectives?
Yes, the focus of this research is in accordance with the research objectives.
The aim of this study was to describe the most recommended pharmacological
management for both hypertensive disorders in pregnancy (pre-eclampsia and
eclampsia).

5.2 Is the research subject taken in appropriate method?

Yes, this search is conducted by using different combinations of key words
such as pre-eclampsia, eclampsia, pharmacology, therapy, pregnancy diseases,
pathophysiology, cardiovascular disease (CVD), pregnancy, and hypertensive
disorders in pregnancy that appear only in the title, abstract , or both. The search was
carried out using the sentence ‘pre-eclampsia OR eclampsia AND pharmacology;
preeclampsia OR eclampsia AND pathophysiology; pre-eclampsia OR eclampsia
AND therapy; disease in pregnancy AND pre-eclampsia OR eclampsia; CVD AND
pregnancy; hypertensive disorders in pregnancy AND pre-eclampsia OR eclampsia.
Searches are stacked for articles which were published from 2011-2017.
5.3 Is the data collected in accordance with the purpose of the research?
Yes, all articles obtained, unrelated, inaccessible, duplicate, and other
language writings are excluded. The bibliography of the articles used in this review is
sought for additional related citations. In addition to PubMed, several documents and
guidelines available from different hospitals and national and international
organizations were also analyzed.
6. Importance

6.1 Is this study important?

Yes, this research is needed to describe the most recommended
pharmacotherapy in antepartum for pre-eclampsia and eclampsia applied in Portugal
and based on several national and international provisions. As is well known that pre-
eclampsia and eclampsia are two hypertensive disorders in pregnancy which are the
main causes of maternal and perinatal morbidity and mortality. In this context, it is
very important to evaluate whether all preventive, safeguarding, and treatment
measures those have been carried out correctly on both hypertensive disorders in this
pregnancy.

7. Applicability

Can this study be applied?

Yes, the results of this study can be applied in Indonesia, because all drug
preparations recommended in this study (nifedipine, labetalol, MgSO4, and
corticosteroids) are available at most of primary health care and hospitals in
indonesia. However, in Indonesia labetalol is not yet available. Therefore, clinicians
can used other preparations those recommended in this study and available in
Indonesia. Cases of pre-eclampsia and eclampsia are 3B competencies based on
SKDI 2012, which means that these two cases are emergency cases that must be
managed early in the primary service until the patient is stable before referral patients
to other facilities.

Conclusion : This journal is valid, important and can be applied so that this journal
can be used as a reference.