Standardized Clinical Assessment and Management Plan to Reduce Readmissions for Postpartum Hypertension

Area of Science:

• Obstetrics and Gynecology
• Cardiology
• Public Health

Background:

• Postpartum hypertension is a significant concern, increasing the risk of readmissions and emergency department (ED) visits.
• Effective management strategies are crucial to mitigate these risks and improve maternal outcomes.

Purpose of the Study:

• To evaluate the impact of a standardized clinical assessment and management plan on postpartum readmissions and ED visits for patients with hypertension.
• To identify risk factors associated with the need for antihypertensive medication adjustments after discharge.

Main Methods:

• A prospective cohort study compared patients with postpartum hypertension under a new standardized plan (postintervention) with a historical control group.
• The plan included medication management for elevated blood pressure and remote blood pressure monitoring post-discharge.
• Multivariable logistic regression and propensity score weighting were used for analysis.

Main Results:

• The standardized plan significantly reduced postpartum readmissions or ED visits for hypertension (2.8% vs 11.0%, adjusted odds ratio [aOR] 0.24, P <.001).
• Remote monitoring compliance was 65.4%, with 20.8% requiring medication adjustments.
• Factors associated with needing adjustments included Non-Hispanic Black race, chronic hypertension, private insurance, and discharge on antihypertensive medications.

Conclusions:

• A standardized clinical assessment and management plan effectively reduced postpartum readmissions and ED visits for hypertensive patients.
• Close outpatient follow-up and medication management are vital, particularly for high-risk populations.