UCLA

Objective: To determine if timely treatment within 60 minutes of confirmed diagnosis of severe maternal hypertension with antihypertensive medications was associated with reduction in severe maternal morbidity.

Methods: Medical records of women with severe hypertension (at least two severe blood pressures, systolic ≥160mmHg and/or diastolic ≥110mmHg, within 60 minutes) were accessed for timing of severe blood pressures, timing of treatment, and blood pressure response to treatment. Severe maternal morbidity was confirmed by multidisciplinary case review. We compared the incidence of severe maternal morbidity between women who received timely (within 60 minutes of diagnosis) vs. not-timely treatment.

Results: Of 465 women with severe hypertension, 29 (6.2%) experienced severe maternal morbidity. Fifty-six percent of women received timely treatment, of whom 1.9% had severe maternal morbidity, compared with 6.4% of women who did not receive timely treatment (p=0.02). Timely treatment was associated with a 72% reduction in relative odds of severe maternal morbidity (p=0.02). No significant difference was seen in median pre-treatment systolic pressures (p=0.20) between the groups.

Conclusion: Antihypertensive treatment within 60 minutes of confirmed diagnosis of severe hypertension was associated with reduction in severe maternal morbidity. Our findings support current recommendations to treat all women with severe hypertension with antihypertensive medications in a timely fashion.