Obstetricians’ knowledge and practices regarding the management of preeclampsia

Carrie M. Snead, Emmie Strassberg, Rachael Overcash, Lauren Stark, Michael J. Paglia, Jay Schulkin, Angie Jelin

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalJournal of Maternal-Fetal and Neonatal Medicine
DOIs
StateAccepted/In press - Jan 1 2019

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Practice Management
Pre-Eclampsia
Mothers
Medicine
Aspirin
Guidelines
Hypertension
Pregnancy
Magnesium Sulfate
New England
Advisory Committees
Practice Guidelines
Publications
Inpatients
Seizures
Biomarkers

Keywords

  • Aspirin
  • biomarkers
  • preeclampsia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Obstetricians’ knowledge and practices regarding the management of preeclampsia. / Snead, Carrie M.; Strassberg, Emmie; Overcash, Rachael; Stark, Lauren; Paglia, Michael J.; Schulkin, Jay; Jelin, Angie.

In: Journal of Maternal-Fetal and Neonatal Medicine, 01.01.2019.

Research output: Contribution to journalArticle

Snead, Carrie M. ; Strassberg, Emmie ; Overcash, Rachael ; Stark, Lauren ; Paglia, Michael J. ; Schulkin, Jay ; Jelin, Angie. / Obstetricians’ knowledge and practices regarding the management of preeclampsia. In: Journal of Maternal-Fetal and Neonatal Medicine. 2019.
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