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Knowledge of hypertensive disorders in pregnancy among obstetricians and midwives
  1. N Suff,
  2. P Jatoth,
  3. A Khalil,
  4. P O'Brien
  1. University College London Hospitals NHS Foundation Trust, London, UK

Abstract

Background Hypertension in pregnancy remains one of the leading causes of maternal deaths in the UK and is associated with an increased lifetime risk of cardiovascular disease.

Methods An anonymous structured questionnaire, based on the National Institute for Health and Clinical Excellence guideline on the diagnosis and management of hypertensive disorders in pregnancy, was circulated among a randomly selected group of obstetricians.

Results Of 107 respondents, only 40% were familiar with the recurrent risk of pre-eclampsia (PE); 14% were unable to define the blood pressure thresholds for the diagnosis of mild and severe hypertension; 66% incorrectly differentiated the diagnosis of PE from gestational hypertension; only 7% gave the correct definition of early-onset PE. 47% thought that the recommended method for checking proteinuria in pregnancy is the visual dipstick while 21% failed to define the urine PCR cut-off in PE. 25% correctly identified two risk groups for whom low-dose aspirin is recommended for the prevention of PE. Only 59% correctly identified the first line antihypertensive drug recommended in pregnancy; 18% correctly stated the blood pressure threshold for treatment of new-onset hypertension in pregnancy; 49% knew the target blood pressure level in women with chronic hypertension. 24% failed to recognise the risk of future cardiovascular disease in a woman who developed PE.

Conclusion Our study has identified significant gaps in both theoretical knowledge and practice. Diagnosis and management of hypertension in pregnancy should be standardised across the UK healthcare system.

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