Implementing Screening Guidelines for Preeclampsia Prevention in a Birth Center: A Quality Improvement Project

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Quality Improvement in Healthcare

Background:

• Preeclampsia poses a significant risk to pregnant individuals receiving birth center care, often necessitating hospital transfer.
• Identifying at-risk patients early is crucial for initiating timely preventative measures and maintaining continuity of care within birth centers.

Purpose of the Study:

• To implement and evaluate a screening protocol for preeclampsia risk factors in birth center patients.
• To assess the impact of screening on the initiation of preventative treatment, specifically low-dose aspirin (LDA).
• To determine the effect of screening and LDA on preeclampsia incidence and hospital transfer rates.

Main Methods:

• A quality improvement project was conducted over 5 weeks, screening pregnant individuals between 12 and 28 weeks' gestation.
• High-risk patients were initiated on low-dose aspirin (LDA).
• All patients were monitored for preeclampsia diagnosis up to two weeks postpartum, with outcomes assessed via chart audits.

Main Results:

• Preeclampsia risk screening significantly increased the utilization of low-dose aspirin (LDA).
• While not statistically significant, preeclampsia screening showed a moderate reduction in incidence.
• Low-dose aspirin (LDA) use demonstrated a large reduction effect on preeclampsia diagnoses.

Conclusions:

• Implementing preeclampsia screening in birth centers increases LDA use and potentially reduces hospital transfers.
• Preeclampsia screening is a cost-effective strategy that enhances patient retention within birth center practices.
• Early identification and intervention for preeclampsia risk factors can improve maternal outcomes and healthcare efficiency.