The purpose of this study is observe outcomes before and after a change in clinical practice in the threshold for management of severe hypertension in pregnancy and the post-partum period. Outcomes will be observed for 10 months under the current (traditional) clinical blood pressure threshold for acute treatment of hypertension, which is \>= 160 millimeters of mercury (mmHg) systolic blood pressure (SBP). This will be followed by one month of education about rationale for the new SBP threshold of \>= 180 mmHg and change of clinical guidelines. Then, there will be 10 months of observation after adopting the updated clinical threshold for acute antihypertensive treatment (\>= 180 SBP).
Study Type
OBSERVATIONAL
Enrollment
1,003
Patients are treated for hypertension if SBP \>= 160 mmHg.
Patients are treated for hypertension if SBP \>= 180 mmHg.
UT Houston
Houston, Texas, United States
Number of patients with Congestive Heart Failure/Pulmonary Edema, hemorrhagic or ischemic Stroke, Acute Kidney Injury (creatinine > 1.5mg/dL), and/or or Myocardial Ischemia.
The primary outcome is a composite outcome, and will be reported as number of patients who have Congestive Heart Failure/Pulmonary Edema, hemorrhagic or ischemic Stroke, Acute Kidney Injury (creatinine \> 1.5mg/dL), and/or Myocardial Ischemia.
Time frame: during the time of delivery hospitalization (about 2 days to 3 months)
Number of patients with non-reassuring fetal heart rate tracing (NR-FHRT) requiring caesarean delivery
Time frame: at the time of delivery
Number of patients with Apgar score < 7 at 5 min
The Apgar score indicates the status of the newborn infant immediately after birth. Apgar score ranges from 0-10, with a higher score indicating a better outcome.
Time frame: 5 minutes after birth
Number of patients with eclampsia
Time frame: during the time of delivery hospitalization (about 2 days to 3 months)
Number of patients with placental abruption
Time frame: during the time of delivery hospitalization (about 2 days to 3 months)
Number of patients with posterior reversible encephalopathy syndrome (PRES)
Time frame: during the time of delivery hospitalization (about 2 days to 3 months)
Number of patients with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome
Time frame: during the time of delivery hospitalization (about 2 days to 3 months)
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