Background The latest confidential enquiry in maternal mortality highlighted that uncontrolled severe hypertension and fluid overload and pulmonary oedema were significant contributors to death from pre-eclampsia. The aim of this study was to examine standards of care of women with severe PET in our institution, to identify areas of potential improvement and to implement change to facilitate this improvement.

Methods In 2007 over an 8 month period a retrospective audit of 52 admissions with severe PET to the High Dependency Unit (HDU) of our hospital was performed. 16 standards of care were examined based on published guidelines, with 5 standards identified as requiring major improvement. A HDU flow chart was designed incorporating an early warning scoring system (EWSS) with the aim of improving patient care. The flow chart was introduced in October 2010 and standard of care has been audited for 22 women with severe pre-eclampsia to date.

Results & Conclusions Introduction of a HDU flow sheet with EWSS has resulted in significant improvement in the monitoring and appropriate response to severe hypertension and in appropriate fluid restriction in cases of severe PET.