Perinatal Outcomes Following Change in Clinical Criteria in for Treatment of Maternal Hypertension

Purpose

The purpose of this study is observe outcomes before and after a change in clinical practice in the threshold for management of severe hypertension in pregnancy and the post-partum period. Outcomes will be observed for 10 months under the current (traditional) clinical blood pressure threshold for acute treatment of hypertension, which is >= 160 millimeters of mercury (mmHg) systolic blood pressure (SBP). This will be followed by one month of education about rationale for the new SBP threshold of >= 180 mmHg and change of clinical guidelines. Then, there will be 10 months of observation after adopting the updated clinical threshold for acute antihypertensive treatment (>= 180 SBP).

Condition

  • Maternal Hypertension

Eligibility

Eligible Ages
All ages
Eligible Genders
Female
Accepts Healthy Volunteers
No

Inclusion Criteria

  • any individual > 20 weeks' gestation in triage or admitted at Children's Memorial Hermann Hospital (CMHH) and with blood pressure with >= 160/110 mmHg

Exclusion Criteria

  • Active seizure, stroke, Congestive Heart Failure (CHF)/pulmonary edema, acute kidney injury (AKI), or myocardial infarction (MI) - A history of stroke, CHF, chronic kidney disease (CKD), MI - Have Hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome or thrombocytopenia (platelets < 100×10^9/L) - Persistent neurologic symptoms including headache >8/10 one hour after analgesic or blurry vision/loss of vision

Study Design

Phase
Study Type
Observational
Observational Model
Case-Control
Time Perspective
Prospective

Arm Groups

ArmDescriptionAssigned Intervention
Traditional clinical blood pressure threshold of SBP >= 160 mmHg for acute treatment of hypertension
  • Procedure: Clinical blood pressure threshold of SBP >= 160 mmHg for acute treatment of hypertension
    Patients are treated for hypertension if SBP >= 160 mmHg.
Updated clinical blood pressure threshold of SBP >= 180 mmHg for acute treatment of hypertension
  • Procedure: Clinical blood pressure threshold of SBP >= 180 mmHg for acute treatment of hypertension
    Patients are treated for hypertension if SBP >= 180 mmHg.

Recruiting Locations

UT Houston
Houston, Texas 77004
Contact:
Kristen A Cagino, MD
518-859-8312
kristen.a.cagino@uth.tmc.edu

More Details

Status
Recruiting
Sponsor
The University of Texas Health Science Center, Houston

Study Contact

Kristen Cagino, MD
713-500-6412
Kristen.A.Cagino@uth.tmc.edu