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Postpartum hypertension – an evidence based audit
  1. A Anbazhagan1,
  2. P Fogarty2,
  3. A Hunter1,
  4. R Harper2
  1. 1Royal Jubilee Maternity Hospital, Belfast, UK
  2. 2Ulster Hospital, Dundonald, Northern Ireland, UK

Abstract

Postpartum hypertension though common (12%) has no universally accepted guidelines regarding its management resulting in confusion for staff and danger to patients.

Aim To review the current practice in the management of women with postpartum hypertension in two hospitals and their follow-up in the community

To draw evidence based protocol for the management of postpartum hypertension.

Methods A retrospective review of the case notes between 2004/2006 at RJMH and Ulster Hospital.

Various medications, their doses and the duration of treatment were noted and questionnaire sent to GPs regarding postnatal blood pressure and proteinuria check.

A protocol was formulated for the management of these patients based on literature review.

Results 23% of postpartum women at the Ulster Hospital and 31% at the RJMS required treatment with antihypertensives during the postpartum period. There was no uniformity in the management of these women and a wide range of antihypertensives were being used.

BP was checked in 92% of the women and proteinuria only in 45% of the women at the postnatal review.

Conclusion Evidence from literature suggests that during the postnatal period antihypertensive agents- atenolol, nifedipine and enalapril should be started and increased in a stepwise fashion as dictated by the blood pressure.

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