Maternal Hypertension Change Package

This is the Change Package for Maternal Hypertension. It includes information relevant to the AIM Severe Hypertension bundle and The Joint Commission requirements.

PREWORK (please complete prior to Learning Session 1 on October 27, 2021)

Resources Comments
Prework Checklist Start here.
Key Driver Diagram The diagram provides the underlying approach for the initiative.
Measure Set This document lists the measures for the initiative.
Measure Tracking Worksheet This document is designed to assist tracking measures.
Project Assessment Scale This scale will be used for assessing progress in the initiative.
Team Aims Worksheet This document provides guidance on overall aims.
WisPQC Data Terms of Use This document is required for sharing data.
Informational Webinar View recorded Webinar.
Download slides. (PDF)

 

SETTING THE FOUNDATION

The Family Voice
Resource(s) Comments
Voices of Impact The Voices of Impact video series is available through the Council on Patient Safety in Women’s Health Care. The goal of the Voices of Impact video series is to elevate the voices of women and families who have experienced severe maternal events. Putting voices to the numbers can bring awareness to this critical issue and empower women and their care providers to make a positive impact.
Voices of Impact: Irving Family’s Story  

 

Getting Started
Resource(s) Comments
Always Events Toolkit Always Events(R) are defined as those aspects of the care experience that should always occur when patients, their family members or other care partners, and service users interact with health care professionals and the health care delivery system. A one page overview is also available.
Illinois Perinatal Quality Collaborative (ILPQC) The section describing the Severe Maternal Hypertension Initiative contains useful information.
Institute for Healthcare Improvement (IHI) The Institute for Healthcare Improvement (IHI), an independent not-for-profit organization based in Boston, Massachusetts, is a leading innovator, convener, partner, and driver of results in health and health care improvement worldwide. At its core, IHI believes everyone should get the best care and health possible. IHI has a commitment to Person- and Family-Centered Care. This page lists resources for getting started.
PDSA Worksheet This worksheet is a component of IHI’s QI Essential Toolkit. The Plan-Do-Study-Act (PDSA) cycle is a useful tool for documenting a test of change. Use this worksheet for each change you test.
QI Project Charter The QI Project Charter provides a rationale and roadmap for team to clarify thinking about what needs to be done and why.
Walk-through Walk-throughs enable providers to understand the experience of care from the patient’s and family’s points of view by going through the experience themselves.
Reducing peripartum disparities
Tools Comments
Improving Health Equity: Assessment Tool for Healthcare Organizations A resource from IHI.
PA AIM Bundle: Improving Severe Hypertension Treatment and Reducing Racial/Ethnic Disparities  
Reduction of Peripartum Racial/Ethnic Disparities (+AIM) This link provides PDFs of the AIM bundle, complete and supplemental resource listings, and other materials.

 

References Comments
Britton LE, Berry DC, Hussey JM. Comorbid Hypertension and Diabetes among U.S. Women of Reproductive Age: Prevalence and Disparities. J Diabetes Complications. 2018;32(12):1148-1152. Comorbid hypertension and diabetes are more common among non-Hispanic black women and less likely to be diagnosed.
Cabacungan ET, Ngui EM, McGinley EL. Racial/ethnic disparities in maternal morbidities: a statewide study of labor and delivery hospitalizations in Wisconsin. Matern Child Health J. 2012;16(7):1455-1467. Findings show significant racial/ethnic disparities in maternal morbidities, and suggest the need for better screening, management, and timely referral of these conditions, particularly among racial/ethnic women.
Fasanya HO, Hsiao CJ, Armstrong-Sylvester KR, Beal SG. A Critical Review on the Use of Race in Understanding Racial Disparities in Preeclampsia. The Journal of Applied Laboratory Medicine. 2021 Jan 12;6(1):247–56.  
Gonzalez C, Early J, Gordon-Dseagu V, Mata T, Nieto C. Promoting Culturally Tailored mHealth: A Scoping Review of Mobile Health Interventions in Latinx Communities. J Immigr Minor Health. 2021 Oct;23(5):1065–77.  
Gyamfi-Bannerman C, Pandita A, Miller EC, Boehme AK, Wright JD, Siddiq Z, et al. Preeclampsia outcomes at delivery and race. The Journal of Maternal-Fetal & Neonatal Medicine. 2019 Feb 20;0(0):1–8.  
MacDorman MF, Thoma M, Declcerq E, Howell EA. Racial and Ethnic Disparities in Maternal Mortality in the United States Using Enhanced Vital Records, 2016‒2017. Am J Public Health. 2021 Sep 1;111(9):1673–81.  
Mayne SL, Yellayi D, Pool LR, Grobman WA, Kershaw KN. Racial Residential Segregation and Hypertensive Disorder of Pregnancy Among Women in Chicago: Analysis of Electronic Health Record Data. Am J Hypertens. 2018;31(11):1221-1227. Racial residential segregation was associated with greater prevalence of hypertensive disorder of pregnancy among those living in higher poverty neighborhoods.
Miller EC, Zambrano Espinoza MD, Huang Y, et al. Maternal Race/Ethnicity, Hypertension, and Risk of Stroke During Delivery Admission. J Am Heart Assoc. 2020;9(3):e014775. Pregnant US women from minority groups had higher stroke risk during delivery admissions, compared with non-Hispanic whites.
Minhas AS, Ogunwole SM, Vaught AJ, Wu P, Mamas MA, Gulati M, et al. Racial Disparities in Cardiovascular Complications With Pregnancy-Induced Hypertension in the United States. Hypertension. 2021 Aug;78(2):480–8.  
Shahul S, Tung A, Minhaj M, et al. Racial Disparities in Comorbidities, Complications, and Maternal and Fetal Outcomes in Women with Preeclampsia/Eclampsia. Hypertens Pregnancy. 2015;34(4):506-515. Results suggest that African-American women are more likely to have risk factors for preeclampsia and more likely to suffer an adverse outcome during peripartum care.
Singh GK, Siahpush M, Liu L, Allender M. Racial/Ethnic, Nativity, and Sociodemographic Disparities in Maternal Hypertension in the United States, 2014-2015. Int J Hypertens. 2018;2018:7897189. Ethnicity, nativity status, older maternal age, and prepregnancy obesity and excess weight gain should be included among the criteria used for screening for gestational hypertension.
Tiako MJN, McCarthy C, Meisel ZF, Elovitz MA, Burris HH, South E. Association between Low Urban Neighborhood Greenness and Hypertensive Disorders of Pregnancy. Am J Perinatol [Internet]. 2021 Aug 27 [cited 2021 Oct 11];  
The Joint Commission
Resource(s) Comments
R3 Report Issue 24: PC Standards for Maternal Safety Effective July 1, 2020, 13 new elements of performance were applicable to Joint Commission-accredited hospitals. Prevention, early recognition, and timely treatment for maternal hemorrhage and severe hypertension/preeclampsia had the highest impact in states working on decreasing maternal complications.

 

READINESS: Every Unit

Standards for early warning signs, diagnostic criteria, monitoring, and treatment
Tools Comments
Maternal Early Warning Criteria A multidisciplinary working group convened by the National Partnership of Maternal Safety used a consensus-based approach to define the Maternal Early Warning Criteria, a list of abnormal parameters that indicate the need for urgent bedside evaluation by a clinician with the capacity to escalate care.
MEOWSSCALE  
MEWS-Protocol  
Sample hospital policy  

 

References Comments
Darwin KC, Federspiel JJ, Schuh BL, Baschat AA, Vaught AJ. ACC-AHA Diagnostic Criteria for Hypertension in Pregnancy Identifies Patients at Intermediate Risk of Adverse Outcomes. Am J Perinatol. 2021 Aug;38(S 01):e249–55.  
DeSisto CL, Robbins CL, Ritchey MD, Ewing AC, Ko JY, Kuklina EV. Hypertension at delivery hospitalization – United States, 2016–2017. Pregnancy Hypertension. 2021 Dec 1;26:65–8.  
Friedman AM, Campbell ML, Kline CR, et al. Implementing Obstetric Early Warning Signs. AJP Rep. 2018;8(2):e79-e84. To reduce maternal risk effectively, early warning systems that capture deterioration from a broad range of conditions may be required in addition to bundles tailored to specific conditions such as hemorrhage, thromboembolism, and hypertension.
Hannola K, Hoppu S, Mennander S, Huhtala H, Laivuori H, Tihtonen K. Obstetric early warning system to predict maternal morbidity of pre-eclampsia, postpartum hemorrhage and infection after birth in high-risk women: a prospective cohort study. Midwifery. 2021 Aug 1;99:103015.  
Hoppu S, Hannola K, Mennander S, Huhtala H, Rissanen M, Tulensalo E, et al. Routine Bedside Use of Obstetric Early Warning System in the Postnatal Ward to Identify Maternal Morbidity Among High-Risk Women. Journal of Patient Safety [Internet]. 2021 Oct 13 [cited 2021 Oct 22];  
Magee LA, Singer J, Lee T, Rey E, Asztalos E, Hutton E, et al. The impact of pre-eclampsia definitions on the identification of adverse outcome risk in hypertensive pregnancy – analyses from the CHIPS trial (Control of Hypertension in Pregnancy Study). BJOG: An International Journal of Obstetrics & Gynaecology [Internet].  
Ogunwole SM, Mwinnyaa G, Wang X, Hong X, Henderson J, Bennett WL. Preeclampsia Across Pregnancies and Associated Risk Factors: Findings From a High‐Risk US Birth Cohort. Journal of the American Heart Association. 2021 Sep 7;10(17):e019612.  
Vidaeff AC, Saade GR, Sibai BM. Preeclampsia: The Need for a Biological Definition and Diagnosis. Am J Perinatol. 2021 Jul;38(09):976–82.  

 

Unit education on protocols, unit-based drills
Resource(s) Comments
Classification and Diagnosis of Hypertensive Disorders of Pregnancy  
E-Modules From the Alliance for Innovation on Maternal Health.
Improving Health Care Response to Preeclampsia: A California Quality Improvement Toolkit  
Preeclampsia Informational Webinar From CMQCC.
Sample Nursing Management Policy and Procedure  
Simulation Scenario: Hypertension in pregnancy, HELLP with seizure  
SMFM Hypertension Webcast From Alliance for Innovation on Maternal Health Care
Rapid access to medications
Tools Comments
Sample Preeclampsia/Eclampsia Medication Toolbox List Appendix S of the CMQCC Preeclampsia Toolkit (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.
Steps for Preparation, Storage, Ordering, and Administration of Magnesium Sulfate Component of CMQCC Preeclampsia Toolkit (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.

 

References Comments
Easterling T, Mundle S, Bracken H, Parvekar S, Mool S, Magee LA, et al. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. The Lancet. 2019 Sep 21;394(10203):1011–21.  
   
System plan for escalation, appropriate consultation, and maternal transport
Tools Comments
Policy for Severe Hypertension in the Obstetrical Patient This is an example of a hospital policy.
WAPC Levels of Care Resources Includes resources related to maternal transport.

RECOGNITION AND PREVENTION: Every patient

Standard protocol for measurement and assessment of BP
Tools Comments
Accurate Blood Pressure Measurement Patient care and treatment recommendation from CMQCC (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.
Taking a Blood Pressure A poster from the Oklahoma PQIC

 

References Comments
Bowen L, Pealing L, Tucker K, McManus RJ, Chappell LC. Adherence with blood pressure self-monitoring in women with pregnancy hypertension, and comparisons to clinic readings: A secondary analysis of OPTIMUM-BP. Pregnancy Hypertension. 2021 Aug 1;25:68–74.  
Herman HG, Barda G, Miremberg H, Gonen N, Torem M, Kleiner I, et al. Management of pregnancies with suspected preeclampsia based on 6-hour vs 24-hour urine protein collection—a randomized double-blind controlled pilot trial. American Journal of Obstetrics & Gynecology MFM. 2021 Sep 1;3(5):100429.  
Hurrell A, Webster L, Chappell LC, Shennan AH. The assessment of blood pressure in pregnant women: pitfalls and novel approaches. American Journal of Obstetrics and Gynecology [Internet]. 2021 Jan 26 [cited 2021 Oct 13];  
Tran K, Padwal R, Khan N, Wright M-D, Chan WS. Home blood pressure monitoring in the diagnosis and treatment of hypertension in pregnancy: a systematic review and meta-analysis. CMAJ Open. 2021 Jun;9(2):E642–50.  

 

Standard response to maternal early warning signs
Resource(s) Comments
Consultation Triggers in Severe Preeclampsia for All Obstetric Units From CMQCC (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.
Nursing Assessment Frequency From CMQCC Preeclampsia Toolkit (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.
Preeclampsia Early Recognition Tool (PERT) From CMQCC Preeclampsia Toolkit (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.
Proteinuria From CMQCC Preeclampsia Toolkit (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.
Treatment for Acute-onset Severe Hypertension during Pregnancy and the Postpartum Period AIM FAQ topic (08/30/2016)

 

References Comments
Choi YJ, Shin S. Aspirin Prophylaxis During Pregnancy: A Systematic Review and Meta-Analysis. American Journal of Preventive Medicine. 2021 Jul 1;61(1):e31–45.  
US Preventive Services Task Force. Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: US Preventive Services Task Force Recommendation Statement. JAMA. 2021 Sep 28;326(12):1186–91.  

 

Standards for educating women on signs/symptoms of hypertension and preeclampsia
Tools Comments
Discharge Information for Patients with Diagnosis of Preeclampsia, HELLP Syndrome or Eclampsia Appendix Q from CMQCC Preeclampsia Toolkit (approved 12/20/2013)
An updated version of the CMQCC toolkit is expected in 2021.
Educating Patients Less than half of well-educated women know the signs and symptoms of preeclampsia. The Preeclampsia Foundation is working to improve the resources available to all women and their caregivers by providing evidence based educational materials in our Store.
Maternal Mental Health: Depression and Anxiety From the Council on Patient Safety in Women’s Health Care
POST-BIRTH Warning Signs Success Story: An Interview with a New Mother AWHONN has developed a standardized approach to ensuring that postpartum parents are empowered to recognize and act on signs of potentially life-threatening postpartum complications.
Preeclampsia Patient-oriented graphic on signs and symptoms from the Preeclampsia Foundation. Graphic can be ordered from the Preeclampsia Foundation. This example is Appendix O from the CMQCC Preeclampsia Toolkit (approved 12/20/2013).
An updated version of the CMQCC toolkit is expected in 2021.
Preeclampsia and Eclampsia Patient-oriented graphic from Froedtert and the Medical College of Wisconsin (07/19)
Preeclampsia (High Blood Pressure during Pregnancy) Patient information from ACOG District II
Prenatal and Postpartum Patient Counseling or Education From CMQCC Preeclampsia Toolkit (approved 12/20/2013).
An updated version of the CMQCC toolkit is expected in 2021.
Sample Discharge Sheet for Hypertensive Disorder Patients Sample from Florida PQC (2/2016)
7 Symptoms Every Pregnant Woman Should Know A brief video by the Preeclampsia Foundation.
Speak Up For New Parents Consumer-oriented resource from The Joint Commission.

 

References Comments
Ahmed S, Brewer A, Tsigas EZ, Rogers C, Chappell L, Hewison J. Women’s attitudes, beliefs and values about tests, and management for hypertensive disorders of pregnancy. BMC Pregnancy Childbirth. 2021 Sep 30;21:665.  
Marshall CJ, Huma Z, Deardorff J, Britton LE. Prepregnancy Counseling Among U.S. Women With Diabetes and Hypertension, 2016–2018. American Journal of Preventive Medicine. 2021 Oct 1;61(4):529–36.  
Tsigas EZ. The Preeclampsia Foundation: the voice and views of the patient and her family. American Journal of Obstetrics & Gynecology [Internet]. 2021 Aug 31 [cited 2021 Sep 14];  
Vinogradov R, Smith VJ, Robson SC, Araujo-Soares V. Informational needs related to aspirin prophylactic therapy amongst pregnant women at risk of preeclampsia – A qualitative study. Pregnancy Hypertension. 2021 Aug 1;25:161–8.  

 

RESPONSE: Every case of severe hypertension/preeclampsia

Standard protocols for hypertensive disorders
Resource(s) Comments
Daily Assessment for Delivery versus Continuing Pregnancy From the CMQCC Preeclampsia Toolkit (approved 12/20/2013).
An updated version of the CMQCC toolkit is expected in 2021.
Eclampsia algorithm  
Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period ACOG Committee Opinion No. 623. February 2015.
Hydralazine algorithm  
Labetalol algorithm  
OB Hypertension This is a sample order set provided by Fort Healthcare.
Oral nifedipine algorithm  
Preeclampsia Early Recognition Tool (PERT)  
Sample Order Sets: Labetalol, Hydralazine, Oral Nifedipine These sample order sets were adapted from Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Committee Opinion No. 692. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017. 129:e90-95.
Severe hypertension checklist  
Suspected preeclampsia algorithm  

 

References Comments
Deshmukh US, Lundsberg LS, Culhane JF, Partridge C, Reddy UM, Merriam AA, et al. Factors associated with appropriate treatment of acute-onset severe obstetrical hypertension. American Journal of Obstetrics and Gynecology. 2021 Sep 1;225(3):329.e1-329.e10.  
Rosenbloom JI, Nelson DM, Saunders S, Cole FS, Chandarlis J, Macones GA, et al. Addressing medically-underserved populations through maternal-fetal transport: A geographic analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2018 Dec 26;0(ja):1–111.  
Schneider P, King PAL, Keenan-Devlin L, Borders AEB. Improving the Timely Delivery of Antihypertensive Medication for Severe Perinatal Hypertension in Pregnancy and Postpartum. Am J Perinatol [Internet]. 2021 May 2 [cited 2021 May 17]  
Spencer NM, Gabra M, Bedell SM, Scott DM, Rauk P. Improving compliance with guidelines for hypertensive disorders of pregnancy through an electronic health record alert: A retrospective chart review. Pregnancy Hypertension. 2021 Aug 1;25:1–6.  
Squire Eppes C, Han SB, Haddock AJ, Buckler AG, Davidson CM, Hollier LM. Enhancing Obstetric Safety Through Best Practices. Journal of Women’s Health [Internet]. 2020 Nov 23 [cited 2020 Nov 30];  
Thompson X, Sullivan MB, Mathura P, Wong A, Crawford J, Sia W. Implementation of a Clinical Decision Laboratory Ordering Algorithm for Preeclampsia: A Quality Improvement Initiative. J Obstet Gynaecol Can. 2020 Oct;42(10):1223-1229.e3.  
Zhu H, Yang Y, Xu Y, Deng X, Yan J, Li T, et al. Effect of a quality improvement intervention with safety-based checklists for perinatal health of hypertension disorders in pregnancy. International Journal of Gynecology & Obstetrics [Internet]. [cited 2021 Oct 18]  
FOLLOW-UP AT DISCHARGE  
Bick D, Silverio SA, Bye A, Chang Y-S. Postnatal care following hypertensive disorders of pregnancy: a qualitative study of views and experiences of primary and secondary care clinicians. BMJ Open. 2020 Jan 19;10(1):e034382.  
Bruce KH, Anderson M, Stark JD. Factors associated with postpartum readmission for hypertensive disorders of pregnancy. American Journal of Obstetrics & Gynecology MFM. 2021 Sep 1;3(5):100397.  
Celi AC, Seely EW, Wang P, Thomas AM, Wilkins-Haug LE. Caring for Women After Hypertensive Pregnancies and Beyond: Implementation and Integration of a Postpartum Transition Clinic. Matern Child Health J. 2019 Nov 1;23(11):1459–66.  
McLaren RA, Magenta M, Gilroy L, Duarte MG, Narayanamoorthy S, Weedon J, et al. Predictors of readmission for postpartum preeclampsia. Hypertension in Pregnancy. 2021 Sep 11;0(0):1–7.  
Palmrich P, Binder C, Zeisler H, Kroyer B, Pateisky P, Binder J. Awareness of obstetricians for long-term risks in women with a history of preeclampsia or HELLP syndrome. Arch Gynecol Obstet [Internet]. 2021 Aug 18 [cited 2021 Oct 13]  
Wen T, Yu VX, Wright JD, Goffman D, Attenello F, Mack WJ, et al. Postpartum length of stay and risk for readmission among women with preeclampsia. J Matern Fetal Neonatal Med. 2020 Apr;33(7):1086–94.  

 

Support plan for patients, families, and staff for ICU admissions and serious complications
Tools Comments
Patient, Family, and Staff Support After a Severe Maternal Event From the Council on Patient Safety in Women’s Health Care. This is a recording of a live event on Oct 14, 2014.
Post-discharge Evaluation: Elevated Blood Pressure An algorithm from ACOG District II
Postpartum Discharge Phone Call Script This script provides suggested language for a range of topics.
Save Your Life: Get Care for These POST-BIRTH Warning Signs

This patient-focused document developed by AWHONN is available in:

 

References Comments
Chou C-C, Liaw J-J, Chen C-C, Liou Y-M, Wang C-J. Effects of a Case Management Program for Women With Pregnancy-Induced Hypertension. Journal of Nursing Research. 2021 Oct;29(5):e169.  

 

REPORTING/SYSTEMS LEARNING: Every unit

Establishing a culture of huddles and post-event debriefs
Resource(s) Comments
ACOG Simulation Eclampsia Formative Eval  
Briefs and Debriefs From AHRQ TeamSTEPPS Pocket Guide
Debriefing Tool From the CMQCC Preeclampsia Toolkit (approved 12/20/2013). This specific tool is for an obstetrical hemorrhage drill.
Obstetric Team Debriefing Form From ACOG District II
PHEW: The Abbreviated Debrief This is a four-step debrief tool.
Role of Medical Simulation From the CMQCC Preeclampsia Toolkit (approved 12/20/2013)
Severe Hypertension Data and Debrief Form From the Alaska PQC (3/5/2020)
Severe Maternal Hypertension Debrief From the Illinois PQC
Teamwork and Communication From the CMQCC Preeclampsia Toolkit (approved 12/20/2013)
Multidisciplinary review for systems issues
Tools Comments
Patient, Family and Staff Support Following a Severe Maternal Event From the Council on Patient Safety in Women’s Health Care Safety Action Series (October 14, 2014)
Sustainability Compliance Data Form From the Illinois PQC (2/15/2018)
Sustainability Plan: Maternal Hypertension Initiative From the Illinois PQC

 

Monitoring outcomes and process metrics
Tools Comments
Severe Maternal Morbidity (long form) Process for reviewing a severe maternal morbidity event from the Council on Patient Safety in Women’s Health Care (6/28/2016)
Severe Maternal Morbidity (short form) Process for reviewing a severe maternal morbidity event from the Council on Patient Safety in Women’s Health Care (6/28/2016)

 

References Comments
Ananth CV, Brandt JS, Hill J, Graham HL, Grover S, Schuster M, et al. Historical and Recent Changes in Maternal Mortality Due to Hypertensive Disorders in the United States, 1979 to 2018. Hypertension. 0(0):HYPERTENSIONAHA.121.17661.  
Flatt SB, Pudwell J, Smith GN. Evaluation of a Postpartum Cardiovascular Risk Screening Clinic: An Analysis of Interpregnancy and Subsequent Pregnancy Outcomes. J Obstet Gynaecol Can. 2021 Aug 21;S1701-2163(21)00608-3.  
Jenabi E, Afshari M, Khazaei S. The association between preeclampsia and the risk of metabolic syndrome after delivery: a meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2021 Oct 2;34(19):3253–8.  
Kountouris E, Clark K, Kay P, Roberts N, Bramham K, Kametas NA. Postnatal assessment for renal dysfunction in women with hypertensive disorders of pregnancy. J Nephrol. 2021 Oct 1;34(5):1641–9.  
Malek AM, Wilson DA, Turan TN, Mateus J, Lackland DT, Hunt KJ. Incident Heart Failure Within the First and Fifth Year after Delivery Among Women With Hypertensive Disorders of Pregnancy and Prepregnancy Hypertension in a Diverse Population. Journal of the American Heart Association. 2021 Sep 7;10(17):e021616.  
Miller EC, Miltiades A, Pimentel-Soler N, Booker WA, Landau-Cahana R, Marshall RS, et al. Cardiovascular and cerebrovascular health after pre-eclampsia: the Motherhealth prospective cohort study protocol. BMJ Open [Internet]. 2021 Jan 7 [cited 2021 May 17];11(1).  
Oshunbade AA, Lirette ST, Windham BG, Shafi T, Hamid A, Gbadamosi SO, et al. Hypertensive Diseases in Pregnancy and Kidney Function Later in Life: The Genetic Epidemiology Network of Arteriopathy (GENOA) Study. Mayo Clinic Proceedings [Internet]. 2021 Sep 24 [cited 2021 Oct 8]  
Plummer MD, Andraweera PH, Garrett A, Leemaqz S, Wittwer M, Aldridge E, et al. Hypertensive disorders of pregnancy and later cardiovascular disease risk in mothers and children. Journal of Developmental Origins of Health and Disease. 2021 Aug;12(4):555–60.  
Wen T, Krenitsky NM, Clapp MA, D’Alton ME, Wright JD, Attenello F, et al. Fragmentation of postpartum readmissions in the United States. Am J Obstet Gynecol. 2020 Jan 18;  

 

INFORMATION FOR EMERGENCY DEPARTMENT PROVIDERS

Readiness
Resource(s) Comments
Are you pregnant…? A sign to support awareness
Triage Decisions Involving Pregnancy-Capable Patients: Educational Deficits and Emergency Nurses’ Perceptions of Risk Wolf LA, Delao AM, Evanovich Zavotsky K, Baker KM. J Contin Educ Nurs. 2021;52(1):21-29.
Recognition
Resource(s) Comments
Emergency Department Recognition and Treatment: Focus on Delayed Postpartum Preeclampsia and Eclampsia From the CMQCC Preeclampsia Toolkit (approved 12/20/2013)
Response
Resource(s) Comments
Evaluation and Treatment of Antepartum and Postpartum Preeclampsia and Eclampsia in the Emergency Department An algorithm from CMQCC
Need to Treat The Ghostbuster-themed poster from the Illinois PQC
Reporting and systems learning
Resource(s) Comments
   
   
   
   
   
   

AFTER HOSPITAL DISCHARGE

Follow-up for hypertension
Resource(s) Comments
Patient perceptions, opinions and satisfaction of telehealth with remote blood pressure monitoring postpartum Thomas NA, Drewry A, Racine Passmore S, Assad N, Hoppe KK. BMC Pregnancy Childbirth [Internet]. 2021 Feb 19 [cited 2021 May 14];21.
Telehealth with remote blood pressure monitoring for postpartum hypertension: A prospective single-cohort feasibility study Hoppe KK, Williams M, Thomas N, Zella JB, Drewry A, Kim K, et al.  Pregnancy Hypertens. 2019 Jan;15:171–6.
Well-woman care (Under Construction)
Resource(s) Comments