Document Detail

The active implementation of pregnancy hypertension guidelines in British Columbia.
MedLine Citation:
PMID:  20733449     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To reduce maternal and perinatal morbidity and mortality associated with the hypertensive disorders of pregnancy by using an active model of guideline implementation. METHODS: This study used a preintervention and postintervention cohort comparison design. We interrogated the British Columbia Perinatal Database Registry for 6 years of existing prospectively gathered data (fiscal years 2000-2001 to 2005-2006), introduced the hypertensive disorders of pregnancy guidelines, and assessed the incidence of the combined adverse maternal and perinatal outcomes for the next 2 years (fiscal years 2006-2007 and 2007-2008). The combined adverse maternal outcome was maternal death, life-threatening, or life-altering complications. The combined perinatal outcome included the severe complications of prematurity and hypoxic-ischemic encephalopathy. RESULTS: Eighteen thousand seventy-six women were diagnosed with hypertensive disorder of pregnancy in British Columbia from 2000-2001 to 2007-2008. Outcomes were compared preguideline (n=13,150 deliveries) and postguideline (n=4,926 deliveries) implementation. The incidence of the combined adverse maternal outcome decreased from 3.1% to 1.9% (relative risk 0.60, 95% confidence interval 0.48-0.75). There was a concomitant fall in the incidence of the combined adverse perinatal outcome. CONCLUSION: The active introduction of standardized management of women with a hypertensive disorder of pregnancy is associated with reduced maternal and perinatal risk. LEVEL OF EVIDENCE: II.
Peter von Dadelszen; Diane Sawchuck; Romy McMaster; M Joanne Douglas; Shoo K Lee; Sarah Saunders; Robert M Liston; Laura A Magee;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  116     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  659-66     Citation Subset:  AIM; IM    
Departments of Obstetrics and Gynaecology, Anesthesiology, Pharmacology and Therapeutics, and Medicine, School of Public and Population Health, Child and Family Research Institute, and Faculty of Medicine, University of British Columbia, and the BC Perinatal Health Program, Vancouver, British Columbia, Canada.
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MeSH Terms
British Columbia / epidemiology
Guideline Adherence*
Hospitals, Community / statistics & numerical data
Hospitals, Maternity / statistics & numerical data
Hypertension, Pregnancy-Induced / epidemiology,  therapy*
Young Adult
Grant Support
//Canadian Institutes of Health Research

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