Recognition and Response to Postpartum Preeclampsia in the Emergency Department

TCHMB’s Recognition and Response to Postpartum Preeclampsia in the Emergency Department (PPED) project aims to reduce maternal morbidity and mortality related to severe hypertension in postpartum patients by: 

  1. Identifying postpartum patients presenting to the Emergency Department (ED) with severe hypertension or preeclampsia
  2. Treating patients identified with severe hypertension in a timely fashion
  3. Improving communication and coordination of care between Emergency Medicine and Obstetric health care teams
  4. Reducing complications from postpartum preeclampsia that led to maternal morbidity and mortality
  5. Reducing racial disparities in health outcomes of Black postpartum patients with severe hypertension or preeclampsia

This will be done by:

  • Providing education to emergency department clinicians

  • Improving processes related to recognition, diagnosis, and treatment of hypertensive disorders of pregnancy and postpartum preeclampsia

  • Facilitating improved communication and collaboration between emergency and maternal departments

  • Developing and disseminating clinical management tools for emergency department clinicians

 
 

Problem Statement

Of the pregnancy–related deaths reviewed by the 2020 Texas Maternal Mortality and Morbidity Review Committee (MMMRC) and Texas Department of State Health Services (DSHS) joint biennial legislative report, 11% had pre-eclampsia and eclampsia as the leading cause of death, and 50% of these deaths occurred within 42 days of delivery.  

If pre-eclampsia and eclampsia had been diagnosed and treated early, these deaths were potentially preventable. The report identified that in 2018, non-Hispanic Black patients had the highest rate of delivery hospitalizations involving hypertension disorders.

“Emergency health providers’ knowledge about maternal physiology and health management, as well as communication and coordination with obstetric and women’s health professionals, can be a critical factor in maternal health outcomes.” 

 

Project Timeline

  • September 29, 2022 at 5:00 pm CST: Project Webinar #1: Project Kickoff Webinar

  • December 2022: Project Orientation packet, Driver Diagram, and Change package shared with participating hospitals

  • January 12, 2023 at 5:00 pm CST: Project Webinar #3: Project Orientation and Data Submission (PowerPoint, YouTube Recording)

  • December 2023: PPED Webinar, go.uth.edu/pped-webinar

  • Data submission due 15th of each month - May 15th is the last day to submit data for the project

  • June 1st: Project Completion Assessment due in REDCap

  • March – May 2024: Participating Hospitals to meet at Texas AIM learning session 3 for collaboration within their RAC/cohorts

  • May 1st, 2024: Final Reinforcement Call

 
 

Texas Maternal Centers Map

Hospital maternal (OB) care levels:

1: Basic care
2: Specialty care
3: Subspecialty care
4: Comprehensive care

 

PPED Webinar

Speaker: Catherine Eppes, MD, MPH
Length: 57:40

To download the course files visit:
go.uth.edu/pped-webinar

 

Treating Preeclampsia

TCHMB developed Understanding Preeclampsia: A Guide for Preeclampsia Awareness Month to support improved care and outcomes for preeclampsia patients in Texas.

Written by Kirsten Handler.

 

Leadership

Project Workgroup Lead

  • Jim Hill, MD, The Children’s Hospital of San Antonio

  • Anita Chary, MD, PhD, Ben Taub