Table 1.
Univariable analysis of the diagnosis and surveillance of women with severe hypertensive disorders during childbirth, comparison of relative risk of outcomes during the ninth to 12th months of the intervention (October 1, 2015, to January 31, 2016) compared with during the baseline period (October 1, 2014, to January 31, 2015).a
| Characteristic | At baseline (n=188) | At 9–12 intervention months (n=196) | P value | RR (95% CI) |
|---|---|---|---|---|
| Time of diagnosis severe hypertensive disorder | ||||
| Prenatal care visit | 9 (4.8) | 9 (4.6) | 0.96 (0.39–2.36) | |
| During admission assessment | 82 (43.6) | 110 (56.1) | 1.29 (1.05–1.58) | |
| After admission assessment | 38 (20.2) | 33 (16.8) | 0.83 (0.55–1.27) | |
| Undiagnosed | 59 (31.4) | 44 (22.4) | 0.72 (0.51–1.00) | |
| Physical examination recorded on diagnosis | ||||
| Minimum: headache, epigastric pain, vision | 25 (13.3) | 41 (20.9) | 1.57 (1.00–2.48) | |
| Blood count: taken: renal and liver function tests as minimum | 23 (12.2) | 61 (31.1) | 2.54 (1.65–3.93) | |
| Documentation sheets at least partially appliedb | ||||
| Women in first stage of labor | 161 | 155 | ||
| Partograph | 114 (70.8) | 107 (69.0) | 0.97 (0.84–1.13) | |
| All study women | 188 | 196 | ||
| Specific observation and treatment sheet for HDP | 86 (45.7) | 91 (46.4) | 1.01 (0.82–1.26) | |
| Fluid balance sheet | 14 (7.4) | 31 (15.8) | 2.12 (1.17–3.86) | |
| Blood pressure | ||||
| BP recorded on admission | 181 (96.3) | 195 (99.5) | 1.03 (1.00–1.06) | |
| Women with known start of active phase of labor | 149 | 140 | ||
| BP recorded at least once during active phase of labor | 127 (85.2) | 121 (86.4) | 1.01 (0.92–1.11) | |
| All study women | 188 | 196 | ||
| BP at least once between delivery and dischargec | 126 (67.0) | 151 (77.0) | 1.15 (1.01–1.30) | |
| Women with vaginal delivery and ≥1 BP recording during admission | 126 | 130 | ||
| Time from last BP till delivery, min | 162 (80–328) | 129 (60–245) | 0.022d | |
| Fetal heart rate | ||||
| Women in active phase of labor, no IUFD | 144 | 131 | ||
| FHR at least once during active phase of labor | 113 (78.5) | 113 (86.3) | 1.10 (0.99–1.23) | |
| Women with recorded FHR | 140 | 164 | ||
| Time from last FHR till delivery, min | 150 (60–296) | 90 (35–180) | 0.001d | |
| Labor progression | ||||
| Women in active phase of labor | 165 | 156 | ||
| <5 h between any two cervical assessmentsd | 103 (62.4) | 112 (71.8) | 1.15 (0.99–1.34) | |
Abbreviations: BP, blood pressure; CI, confidence interval; FHR, fetal heart rate; HDP, hypertensive disorders in pregnancy; IUFD, intrauterine fetal death; relative risk.
Values are given as number (percentage), absolute number, or median (interquartile range), unless indicated otherwise.
The documentation sheets included a partograph sheet (at least the first cervical dilatation in active labor plotted correctly on the alert line), a specific sheet for HDP (at least one recorded observation and treatment, and fluid balance sheet (at least one recording of input and output).
Overall, 70/188 (37%) at baseline and 82/196 (42%) during the intervention had at least one BP recording every 24 h during the first 2 days postpartum (RR 1.12, 95% CI 0.88–1.44).
By Mann‐Whitney test for difference. This incude the interval between the last recording of cervical dilatation and delivery.