Early warning system hypertension thresholds to predict adverse outcomes in pre-eclampsia: A prospective cohort study.

ABSTRACT: OBJECTIVES:To evaluate the association between blood pressure (BP) measurements and adverse outcomes in women with pre-eclampsia. STUDY DESIGN:A prospective cohort study of women with pre-eclampsia admitted to three South African tertiary facilities. BP was measured using the CRADLE Vital Signs Alert (VSA), incorporated with a traffic light early warning system; green: systolic BP <140?mmHg and diastolic BP <90?mmHg, yellow: systolic BP 140-159 and/or diastolic BP 90-109?mmHg (but neither is above the upper threshold), red: systolic BP ?160?mmHg and/or diastolic BP ?110?mmHg. MAIN OUTCOME MEASURES:Maternal: death, eclampsia, stroke, kidney injury; process measures: magnesium sulfate use, Critical Care Unit (CCU) admission; perinatal: stillbirth, neonatal death, preterm delivery. RESULTS:Of 1547 women with pre-eclampsia (including 42 twin pregnancies), 33.0% of women triggered a red light on admission and 78.6% at their highest BP. Severe hypertension and adverse outcomes were common across yellow and red categories. Comparing admission red to yellow lights, there was a significant increase in kidney injury (OR 1.74, CI 1.31-2.33, trend test p?=?.003), magnesium sulfate use (OR 3.40, CI 2.24-5.18, p?

SUBMITTER: Nathan HL 

PROVIDER: S-EPMC6008490 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature