Evaluation of the role of day assessment unit in the management of pregnancy induced hypertension

• Published in: Journal of obstetrics and gynaecology Vol. 25; no. 7; p. 651
• Main Authors: Saleh, M M, Selinger, M
• Format: Journal Article
• Language: English
• Published: England 01.10.2005
• Subjects: Ambulatory Care - standards; Blood Chemical Analysis; Blood Pressure Monitoring, Ambulatory - standards; Female; Follow-Up Studies; Guideline Adherence; Humans; Hypertension, Pregnancy-Induced - diagnosis; Hypertension, Pregnancy-Induced - therapy; Maternal Health Services - methods; Monitoring, Physiologic - standards; Practice Guidelines as Topic; Pregnancy; Pregnancy Outcome; Prospective Studies; Proteinuria - diagnosis; Severity of Illness Index; Time Factors
• ISSN: 0144-3615; 1364-6893
• DOI: 10.1080/01443610500278345

This study is based on an audit designed to investigate observance of the guideline on pregnancy induced hypertension (PIH) and referral to the day assessment unit (DAU) at the Royal Berkshire Hospital. The audit included 60 patients; all were first time referrals, over a period of 4 months in 2003. The main sources of cases were the community (50%), followed by the antenatal clinic (ANC) 47%. The majority (67%) were referred with hypertension. A total of 28% had suspected symptomatic pre-eclampsia. About 94% of the patients were at >or= 32 weeks' gestation. After assessment in the unit, it was found that about 47% had a diastolic blood pressure of <90 mmHg and 77% had no proteinuria. Nearly all the cases referred with symptoms were found to be asymptomatic on review. The laboratory investigations were normal in over 92% of cases. In spite of these findings, 65% of patients were followed-up in ANC and DAU. The audit showed the need for the local guideline.