Society for Maternal-Fetal Medicine Special Statement: A quality metric for evaluating timely treatment of severe hypertension - 26/01/22

Doi : 10.1016/j.ajog.2021.10.007

Society for Maternal-Fetal Medicine (SMFM)
C. Andrew Combs, MD, PhD, John R. Allbert, MD, Afshan B. Hameed, MD, Elliott K. Main, MD, Isabel Taylor, MS, Christie Allen, MSN, RN
SMFM Patient Safety and Quality Committee^⁎
Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA. pubs@smfm.org

^∗Corresponding author: SMFM Patient Safety and Quality Committee.

Abstract

Severe hypertension in pregnancy is a medical emergency. Although expeditious treatment within 30 to 60 minutes is recommended to reduce the risk of maternal death or severe morbidity, treatment is often delayed by >1 hour. In this statement, we propose a quality metric that facilities can use to track their rates of timely treatment of severe hypertension. We encourage facilities to adopt this metric so that future reports from different facilities will be based on a uniform definition of timely treatment.

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Key words : antihypertensive treatment, chronic hypertension, gestational hypertension, hydralazine, labetalol, nifedipine, patient safety, preeclampsia, superimposed preeclampsia

Plan

Introduction

Measure Description

Critique of the Measure

Potential Uses of the Metric

Next Steps

	The Alliance for Innovation on Maternal Health (AIM) is a cooperative agreement between the American College of Obstetricians and Gynecologists (ACOG) and the Maternal Child Health Bureau of the United States Health Resources and Services Administration. AIM seeks to provide standardized approaches to address the drivers of maternal mortality and severe maternal morbidity in the United States. E.M. is a Consulting Quality Improvement Director for AIM. I.T. and C.A. are ACOG staff for the AIM program.
	All authors and Committee members have filed a disclosure of interests delineating personal, professional, business, or other relevant financial or nonfinancial interests in relation to this publication. Any substantial conflicts of interest have been addressed through a process approved by the Society for Maternal-Fetal Medicine (SMFM) Board of Directors. SMFM has neither solicited nor accepted any commercial involvement in the specific content development of this publication.
	This document has undergone an internal peer review through a multilevel committee process within SMFM. This review involves critique and feedback from the SMFM Patient Safety and Quality and Document Review Committees and final approval by the SMFM Executive Committee. SMFM accepts sole responsibility for document content. SMFM publications do not undergo editorial and peer review by the American Journal of Obstetrics & Gynecology. The SMFM Patient Safety and Quality Committee reviews publications every 36 to 48 months and issues updates as needed. Further details regarding SMFM Publications can be found at publications.
	SMFM recognizes that obstetrical patients have diverse gender identities and is striving to use gender-inclusive language in all of its publications. SMFM will be using terms such as “pregnant person/persons” or “pregnant individual/individuals” instead of “pregnant woman/women” and will use the singular pronoun “they.” When describing the study populations used in research, SMFM will use the gender terminology reported by the study investigators.
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