Hypertension in pregnancy: do consensus statements make a difference?

Publisher: Wiley-Blackwell Country of Publication: Australia NLM ID: 0001027 Publication Model: Print Cited Medium: Print ISSN: 0004-8666 (Print) Linking ISSN: 00048666 NLM ISO Abbreviation: Aust N Z J Obstet Gynaecol Subsets: MEDLINE

Publication: Melbourne : Wiley-Blackwell
Original Publication: Melbourne : Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Guideline Adherence* ; Practice Guidelines as Topic*; Practice Patterns, Physicians'/*statistics & numerical data ; Pre-Eclampsia/*prevention & control ; Prenatal Care/*standards; Adult ; Aged ; Australia/epidemiology ; Blood Pressure ; Consensus Development Conferences as Topic ; Female ; Gestational Age ; Humans ; Male ; Middle Aged ; New Zealand/epidemiology ; Pregnancy ; Proteinuria ; Surveys and Questionnaires

Objectives: (i) To document variation in management of hypertension in pregnancy; (ii) to determine whether this variation falls within current management guidelines; and (iii) to make recommendations for developing future guidelines.
Design: Questionnaire-based survey.
Setting: Australia and New Zealand.
Population: All specialist obstetricians.
Methods: Questionnaires were sent to 1198 obstetricians in Australia and New Zealand. Those returned by respondents currently in obstetric practice were analysed. Information was obtained on their current clinical practices relating to the diagnosis and management of hypertension in pregnancy.
Results: Of 1198 obstetricians surveyed, 973 (81%) replied. Of these, 686 (71%) were responsible for obstetric care. Considerable variation in practice was found, particularly in relation to the measurement of blood pressure, the determination of hypertension and significant proteinuria, and the decision to institute antihypertensive drug treatment. The recommendations of the Australasian 1993 Consensus Statement appeared to have had little influence on practice. There has been a striking increase in the use of magnesium sulphate for the prevention of convulsions in preeclampsia.
Conclusions: There is significant variation in management of hypertensive pregnancies that differs from current guidelines. It is not known whether this diversity adversely affects clinical outcomes. Until further outcome evidence is available, consensus statements may be better confined to basic aspects of management for which there is high level evidence.

Date Created: 20021031 Date Completed: 20030131 Latest Revision: 20190901

20231215

10.1111/j.0004-8666.2002.00371.x

12403283