| The active implementation of pregnancy hypertension guidelines in British Columbia. | |
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MedLine Citation:
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PMID: 20733449 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 116 ISSN: 1873-233X ISO Abbreviation: Obstet Gynecol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-24 Completed Date: 2010-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 659-66 Citation Subset: AIM; IM |
Affiliation:
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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. pvd@cw.bc.ca |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult British Columbia / epidemiology Female Guideline Adherence* Hospitals, Community / statistics & numerical data Hospitals, Maternity / statistics & numerical data Humans Hypertension, Pregnancy-Induced / epidemiology, therapy* Pregnancy Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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//Canadian Institutes of Health Research |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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