Poster Session 4
Gillian Piltch, MD
Maternal-Fetal Medicine Fellow
Northwell
Astoria, New York, United States
Rachel P. Gerber, MD
Fellow, Maternal Fetal Medicine
Northwell
New Hyde Park, New York, United States
Chisom Chigozie-Nwosu, BA
Medical Student
Zucker School of Medicine at Hofstra/Northwell
Hempstead, New York, United States
Burton Rochelson, MD
Chief, Maternal-Fetal Medicine
Northwell
New Hyde Park, New York, United States
Matthew J. Blitz, MD
Director of Clinical Research, Maternal-Fetal Medicine, Northwell; Program Director, Maternal Fetal Medicine Fellowship, South Shore University Hospital
Northwell
Bay Shore, NY, United States
Evelina Grayver, MD
Northwell
New Hyde Park, New York, United States
Alejandro D. Alvarez, MPH
Northwell
New Hyde Park, New York, United States
David Krantz, MA
Northwell
New Hyde Park, New York, United States
Caroline Pessel, MD
Northwell
New Hyde Park, New York, United States
Multicenter retrospective cohort study of pregnant or postpartum people who received treatment with immediate release nifedipine or intravenous labetalol or hydralazine for severe hypertension due to preeclampsia with severe features from 2017-2022. Primary outcomes were time to resolution of severe hypertension and resolution of severe hypertension within 30 minutes. Secondary outcomes were number of fast-acting antihypertensive doses and of distinct ACOG-defined medication algorithms needed for resolution of severe hypertension. Log-rank tests, likelihood ratio tests, and t-tests were performed with p< 0.05 considered statistically significant.
Results:
1191 people met inclusion criteria. Range in pulse pressure of the severe blood pressure immediately prior to fast-acting antihypertensive administration was 24-132 mmHg and in time to resolution of severe hypertension was 10-295 minutes. There was no relationship between pulse pressure of the severe blood pressure immediately prior to treatment (Figure 1) or change in pulse pressure between the two severe blood pressures prompting treatment (Figure 2) and time to resolution of severe hypertension. Pulse pressure was not predictive of resolution of severe hypertension within 30 minutes (p=0.10). Subgroup analysis stratified by first fast-acting antihypertensive administered demonstrated no relationship between pulse pressure and resolution within 30 minutes among those who received immediate release nifedipine (p=0.23) or intravenous labetalol (p=0.48) or hydralazine (p=0.45). There was no association between pulse pressure and number of doses of fast-acting antihypertensives (p=0.74) needed for resolution. There was a wider range in pulse pressures that included narrower pulse pressures among people who required one medication compared to those who needed more than one (p < 0.01) for resolution.
Conclusion:
Pulse pressure was not predictive of time to resolution of severe hypertension in preeclampsia with severe features.
