Resources

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PQCNC Challenges in the Diagnosis of Preeclampsia

ACOG Practice Bulletin Diagnosis and Management of Preeclampsia and Eclampsia:  This bulletin provides guidelines for the diagnosis and management of hypertensive disorders unique to pregnancy, as well as the various associated complications.  Note: No link as ACOG has specifically asked that this information NOT be shared.

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals:  Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure–related risk, and to guide management.  This article provides recommendations from the American Heart Association on correct blood pressure monitoring.

Alternative magnesium sulphate regimens for women with preeclampsia and eclampsia:  Cochran review  to assess the comparative effects of alternative regimens for the administration of magnesium sulphate when used for the care of women with pre-eclampsia or eclampsia, or both.

Antihypertensive drug therapy for mild to moderate hypertension during pregnancy:  Cochran review to assess the effects of antihypertensive drug treatments for women with mild to moderate hypertension during pregnancy

ACOG Practice Bulletin - Chronic Hypertension in Pregnancy:  The purpose of this document is to review the effects of chronic hypertension on pregnancy, to clarify the terminology and criteria used to define and diagnose it during pregnancy, and to review the available evidence for management options. Note: No link as ACOG has specifically asked that this information NOT be shared.

Diagnosis and Management of Gestational Hypertension and Preeclampsia:  This article provides diagnosis criteria and classifications of hypertension in pregnancy and management strategies.

Magnesium sulfate prophylaxis in preeclampsia:  Lessons learned from recent trials:  Article that discusses recent trials using magnesium sulfate in preeclampsia

Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial:  a randomized placebo controlled trial:  The Magpie Trial (MAGnesium sulphate for Prevention of Eclampsia) was a large international trial designed to evaluate the effects of magnesium sulphate on women and their babies. The aim was to find out if, overall, women with pre-eclampsia or their children, or both, do better if they are given magnesium sulphate rather than placebo, regardless of whether treatment is started before or after delivery and irrespective of any previous anticonvulsant therapy

Evaluation and management of severe preeclampsia before 34 weeks’ gestation:  Objective was to review the risks and benefits of expectant management of severe preeclampsia remote from term, and to provide recommendations for expectant management, maternal and fetal evaluation, treatment, and indications for delivery.

Management of Late Preterm and Early-Term Pregnancies Complicated by Mild Gestational Hypertension/Pre-Eclampsia:  Provides summaries of studies and treatment recommendations

Magnesium Sulfate in Women With Mild Preeclampsia:  A Randomized Controlled Trial:  A randomized control trial with the objective to determine whether magnesium sulfate prevents disease progression in women with mild preeclampsia.

Management of hypertensive disorders during pregnancy:  summary of NICE guidance:  A summary of guidelines in the treatment of hypertension

Oral beta-blockers for mild to moderate hypertension during pregnancy:   Cochran review to assess whether oral beta-blockers are better than placebo, or no beta-blocker, and have advantages over other antihypertensives, for women with mild to moderate pregnancy hypertension.

How to manage hypertension in pregnancy effectively:  Article discusses management of hypertension and other aspects of care for the hypertensive pregnant patient

Prediction of adverse maternal outcomes in pre-eclampsia development and validation of the fullPIERS model:  The fullPIERS model identifi es women at increased risk of adverse outcomes up to 7 days before complications arise and can thereby modify direct patient care (eg, timing of delivery, place of care), improve the design of clinical trials, and inform biomedical investigations related to pre-eclampsia.

Instituting Surveillance Guidelines and Adverse Outcomes in Preeclampsia:  A study to assess the incidence of combined adverse maternal and perinatal outcomes in women with preeclampsia before and after introducing standardized assessment and surveillance.

WHO recommendations for Prevention and treatment of pre-eclampsia and eclampsia:  Recommendations from the World Health Organization on prevention and treatment of preeclampsia and eclampsia

Pregnancy Medical Home Program Care Pathway:  Management of women with hypertensive disorders of pregnancy.  This pathway provides definitions of the disorders to better standardize the language used with hypertension and details management of each stage of hypertension.

Improving Health Care Response to Preeclampsia: A California Quality Improvement Toolkit - The toolkit provides a series of articles on best practices for hypertensive disorders that range in topic from diagnostic challenges to appropriate implementation of accepted medical therapy and recognition of institutional limitations in providing care for these complex maternal patients. Of particular interest, the toolkit addresses the management of severe preeclampsia < 34 weeks, the importance of recognition and treatment of delayed postpartum preeclampsia/eclampsia in the emergency department and early postpartum follow-up upon discharge. In addition, the toolkit provides care guideline summaries (in checklist, flowchart and table chart formats)