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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 3

(786) Interdisciplinary Pregnancy Hypertension Alert System to Reduce Morbidity Associated with Hypertensive Disorders of Pregnancy (HDP)

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: To create a Pregnancy-Related Hypertension Alert to trigger a timely assessment, diagnosis, and management of hypertensive disorders of pregnancy (HDP) in the Emergency Department (ED).

Study Design: Emergency Medicine (EM) and Obstetrics (OB) teams collaborated to develop and implement the Pregnancy-Related Hypertension Alert. Patients with an elevated blood pressure (BP) defined as a systolic BP of ≥ 150 mmHg and or a diastolic of ≥ 100 mmHg at ≥ 20 weeks gestational age or within 6-weeks postpartum met criteria for the alert. When triggered, an OB resident, OB nurse and EM team immediately evaluated patient using a standardized HDP care pathway.  Treatment according to the pathway includes the use of oral IR nifedipine, IV labetalol, IV hydralazine, and patients with mild elevated BP received oral antihypertensive. 

Results: 80 patients (17 pre-alert; 63 post-alert) were included in the study. BP recheck within 15 minutes was noted in 41% of patients’ pre-alert and increased to 86% post-alert. Median time for patients to receive antihypertensives was 72 minutes [IQR 37.5-195.5] in the pre-alert period and improved to 23.5 minutes [IQR 15- 67 minutes] with the alert . Pre-alert the ED median length of stay was 219 minutes [IQR 182-297 minutes] and reduced to 147 minutes [IQR 73-231 minutes] with the alert. Patient disposition was to Inpatient Obstetrics Unit (pre-alert: 41%; post-alert: 52%), IR/SICU (pre alert: 0%; post alert: 3%), Labor & Birth/Triage (pre alert: 6%; post-alert:13%), transfer from satellite ED to main ED for additional management (5%), home (pre-alert: 53%; post-alert: 25%), other (2%).

Conclusion: After alert implementation, more patients achieved guideline recommended care including BP check and delivery of antihypertensives.  Future directions include ongoing optimization of the HDP alert and expanding coverage of the program across the health care system.