Obstetricians’ knowledge and practices regarding the management of preeclampsia.
Autor: Snead, Carrie M.; Strassberg, Emmie; Overcash, Rachael; Stark, Lauren; Paglia, Michael J.; Schulkin, Jay; Jelin, Angie
Publication year: 2020
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
issn:1476-4954 1476-7058
doi: 10.1080/14767058.2019.1566311
Abstract:
Background: Preeclampsia affects over 4% of pregnancies in the United States. Management of preeclampsia is dependent on the severity of the condition and can range from expectant management to early delivery and inpatient observation. After publication of the hypertension in Pregnancy Task Force guidelines in 2013, little is known about their implementation and acceptance by practicing obstetricians and maternal-fetal medicine (MFM) specialists.Objective: To evaluate Obstetricians’ knowledge and practices regarding the management of preeclampsia.Methods: A prospective survey was administered to ob-gyns at three different hospital systems in the Northeastern United States to assess practices regarding preeclampsia management and prevention.Results: A total of 87 out of 130 providers completed and returned a questionnaire (66.9% response rate). Providers with a subspecialty in MFM made up 44.3% of the sample. 90.7% of respondents agreed that preeclampsia is a common diagnosis in their practice, while 85% agreed that aspirin is useful for reducing a patient’s risk of preeclampsia. 68.8% of providers reported not administering magnesium sulfate in labor to reduce seizure risk in patients with preeclampsia without severe features. Only 5.8% of providers reported using a preeclampsia prediction algorithm, all of whom were MFMs. Providers who specialized in MFM were more likely to prescribe aspirin for preeclampsia prevention in patients with chronic hypertension (26, 74.3% vs. 17, 39.5%, p = .002). MFM specialists were also more likely to counsel patients with abnormal biomarkers on the risk of preeclampsia (23, 69.7% vs. 15, 35.7%, p = .005).Conclusion: Efforts to inform practicing ob-gyns about the best practices for preeclampsia management and prevention have been largely successful, though there are still discrepancies between current recommendations and practice. Differences between general OBGYNs and MFM specialists were also significant with regards to practice. Given the acknowledgement of how common diagnoses of preeclampsia are in respondents’ practices, better education and distribution of guidelines on management of preeclampsia is needed.
Language: eng
Rights:
Pmid: 30669908
Tags: Humans; Female; Prospective Studies; biomarkers; Pregnancy; United States; *Physicians; *Obstetrics; preeclampsia; Aspirin; *Pre-Eclampsia/diagnosis/prevention & control; Aspirin/therapeutic use
Link: https://pubmed.ncbi.nlm.nih.gov/30669908/
