Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle Implementation
Abstract Objective To describe the implementation and early results of the American College of Obstetricians and Gynecologists District II Safe Motherhood Initiative's Severe Hypertension in Pregnancy bundle on the timely treatment of severe hypertension in New York State obstetric...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2018-10-01
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| Series: | American Journal of Perinatology Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673632 |
| _version_ | 1818976165313904640 |
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| author | Lynn L. Simpson Burton Rochelson Cande V. Ananth Peter S. Bernstein Mary D'Alton Cynthia Chazotte Jessica A. Lavery Kristin Zielinski |
| author_facet | Lynn L. Simpson Burton Rochelson Cande V. Ananth Peter S. Bernstein Mary D'Alton Cynthia Chazotte Jessica A. Lavery Kristin Zielinski |
| author_sort | Lynn L. Simpson |
| collection | DOAJ |
| description | Abstract
Objective To describe the implementation and early results of the American College of Obstetricians and Gynecologists District II Safe Motherhood Initiative's Severe Hypertension in Pregnancy bundle on the timely treatment of severe hypertension in New York State obstetric hospitals.
Methods This is a retrospective comparative study of two time periods during voluntary implementation of the Severe Hypertension in Pregnancy bundle in New York State's obstetric hospitals. The main outcome measure was the administration of an appropriate antihypertensive agent within 1 hour of the second elevated value for all pregnant or postpartum patients with severe hypertension.
Results Of the 117 obstetric hospitals participating in the Safe Motherhood Initiative, 111 (94.9%) submitted data included in this analysis. During the study period, 80 of the 111 (72.0%) hospitals reported implementing the hypertension bundle. Overall, 2.4% of pregnant women were diagnosed with severe hypertension, and 60 to 65% of patients were treated within an hour of the second elevated value. Although not statistically significant, a greater numbers of patients were treated within an hour of the second elevated value in the second time period compared with the first in most obstetric hospitals (overall 64.8 vs. 60.8%; p = 0.33).
Conclusion There were increasing numbers of patients receiving timely treatment of severe hypertension during early implementation of a Severe Hypertension in Pregnancy bundle in New York State obstetric hospitals. However, bundle implementation requires significant financial and human resources and the long-term impact on maternal morbidity and mortality in our state remains uncertain.
Precis There was a tendency toward more timely treatment of severe hypertension following implementation of a Severe Hypertension in Pregnancy bundle in New York obstetric hospitals. |
| first_indexed | 2024-12-20T16:07:30Z |
| format | Article |
| id | doaj.art-ef168f1238a8450f8c970761aa593730 |
| institution | Directory Open Access Journal |
| issn | 2157-6998 2157-7005 |
| language | English |
| last_indexed | 2024-12-20T16:07:30Z |
| publishDate | 2018-10-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | American Journal of Perinatology Reports |
| spelling | doaj.art-ef168f1238a8450f8c970761aa5937302022-12-21T19:34:05ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052018-10-010804e212e21810.1055/s-0038-1673632Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle ImplementationLynn L. Simpson0Burton Rochelson1Cande V. Ananth2Peter S. Bernstein3Mary D'Alton4Cynthia Chazotte5Jessica A. Lavery6Kristin Zielinski7Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New YorkDivision of Maternal-Fetal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New YorkDepartment of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, New YorkDivision of Maternal-Fetal Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New YorkDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New YorkDivision of Maternal-Fetal Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New YorkDepartment of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, New YorkAmerican College of Obstetricians and Gynecologists District II, Albany, New YorkAbstract Objective To describe the implementation and early results of the American College of Obstetricians and Gynecologists District II Safe Motherhood Initiative's Severe Hypertension in Pregnancy bundle on the timely treatment of severe hypertension in New York State obstetric hospitals. Methods This is a retrospective comparative study of two time periods during voluntary implementation of the Severe Hypertension in Pregnancy bundle in New York State's obstetric hospitals. The main outcome measure was the administration of an appropriate antihypertensive agent within 1 hour of the second elevated value for all pregnant or postpartum patients with severe hypertension. Results Of the 117 obstetric hospitals participating in the Safe Motherhood Initiative, 111 (94.9%) submitted data included in this analysis. During the study period, 80 of the 111 (72.0%) hospitals reported implementing the hypertension bundle. Overall, 2.4% of pregnant women were diagnosed with severe hypertension, and 60 to 65% of patients were treated within an hour of the second elevated value. Although not statistically significant, a greater numbers of patients were treated within an hour of the second elevated value in the second time period compared with the first in most obstetric hospitals (overall 64.8 vs. 60.8%; p = 0.33). Conclusion There were increasing numbers of patients receiving timely treatment of severe hypertension during early implementation of a Severe Hypertension in Pregnancy bundle in New York State obstetric hospitals. However, bundle implementation requires significant financial and human resources and the long-term impact on maternal morbidity and mortality in our state remains uncertain. Precis There was a tendency toward more timely treatment of severe hypertension following implementation of a Severe Hypertension in Pregnancy bundle in New York obstetric hospitals.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673632severe hypertensionbundle implementationsafe motherhoodtimely treatment |
| spellingShingle | Lynn L. Simpson Burton Rochelson Cande V. Ananth Peter S. Bernstein Mary D'Alton Cynthia Chazotte Jessica A. Lavery Kristin Zielinski Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle Implementation American Journal of Perinatology Reports severe hypertension bundle implementation safe motherhood timely treatment |
| title | Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle Implementation |
| title_full | Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle Implementation |
| title_fullStr | Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle Implementation |
| title_full_unstemmed | Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle Implementation |
| title_short | Safe Motherhood Initiative: Early Impact of Severe Hypertension in Pregnancy Bundle Implementation |
| title_sort | safe motherhood initiative early impact of severe hypertension in pregnancy bundle implementation |
| topic | severe hypertension bundle implementation safe motherhood timely treatment |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0038-1673632 |
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