Conservative Management of Preeclampsia (CMOP): A North Carolina Quality Improvement Project [08L]. (May 2020)

• Record Type: Journal Article
• Authors: Ollendorff, Arthur; Cochran, Keith; DeJoseph, Jodi; Greenberg, Rachel; Gutierrez, Susan; McCaffrey, Marty
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000664584.29984.08
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: According to birth certificate data, hypertension in pregnancy is a leading cause of premature births in North Carolina. A quality improvement project was developed using the 2014 Hypertension in Pregnancy guidelines to properly diagnose hypertensive disorders of pregnancy and see which diagnoses led to premature birth. METHODS: Birthing hospitals in North Carolina participated in a quality improvement project sponsored by the Perinatal Quality Collaborative of North Carolina. In phase one of the project, hospitals attended a series of monthly webinars, semiannual face-to-face meetings and received periodic support from the PQCNC core team to review best practices to correctly diagnose each of the hypertensive disorders. Hospitals submitted monthly data about their delivered mothers with any hypertension in pregnancy diagnosis through a secure web portal. RESULTS: Twenty-two birthing hospitals participated in phase one of the project between March 2015 and March 2016 accounting for 56, 743 deliveries (48% of the deliveries in the state). There were 7, 550 women (13.3%) with any hypertension in pregnancy diagnosis. 661 of these women delivered prior to 34 weeks and 1254 delivered prior to 37 weeks. The cost common hypertension diagnosis related to prematurity was preeclampsia with severe features (48%). CONCLUSION: More than half of the premature infants born to mothers with hypertension in North Carolina were delivered with a diagnosis other than preeclampsia with severe features. With a more complete picture of the severity of hypertension in pregnancy and the role it plays in prematurity in North Carolina, women's health leaders in the state can define potential interventions.