Management of Postpartum Preeclampsia (MOPP)

Rutgers The State University of New Jersey

Status: Completed

Conditions: Postpartum Preeclampsia

Treatments: Other: Tight postpartum blood pressure control

Study type: Interventional

Funder types: Other

Identifiers

NCT05775744

Pro2022001222

Details and patient eligibility

About

The aim of this study is to assess the effect of a lower treatment threshold for antihypertensive medication and tighter blood pressure control, using remote blood pressure monitoring, on reducing Emergency Room visits for our postpartum patients with hypertensive disease.

Full description

The aim of this study is to assess the effect of lower treatment threshold for initiating antihypertensive medication and tighter blood pressure control, using remote blood pressure monitoring, on reducing Emergency Room visits for our postpartum patients with hypertensive disease.

The investigators will study and compare two cohorts of patients. The first is a retrospective cohort, including patients delivered at Robert Wood Johnson University Hospital and Cooperman Barnabas Medical Center. The second is a prospective cohort that will enroll patients immediately postpartum who are eligible for our treatment protocol.

Enrollment: 392 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Chronic hypertension, gestational hypertension, or preeclampsia.
• Delivery of a neonate after 20 weeks during their current hospitalization
• Able to consent
• 18 years old or above
• English or Spanish speaking
• Planning to follow up with a physician associated with Robert Wood Johnson University Hospital or Cooperman Barnabas Medical Center
• Ability to follow directions

Exclusion criteria

• Any medical condition that the providers feel is a contraindication to the MOPP algorithm.
• Planning to follow up with an outside institution.
• Unwillingness to take blood pressure at home.

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

---

392 participants in 2 patient groups

Prospective interventional arm

Experimental group

Description:

The prospective cohort will identify patients in the postpartum period of their delivery hospitalization who are at risk of readmission for hypertensive disorders in the initial six weeks postpartum. Those at risk include patients with diagnosed with chronic hypertension or PIH. Chronic hypertension is defined as either taking antihypertensive medications or a blood pressure of greater than or equal to 140/90 mm Hg prior to 20 weeks of gestation. Pregnancy induced hypertension includes gestational hypertension, preeclampsia without severe features, preeclampsia with severe features and Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP). The minimum requirement to be diagnosed with this spectrum of disorders is having two blood pressures of greater than or equal to 140/90 mm Hg during the antepartum, intrapartum or postpartum periods.

Treatment:

Other: Tight postpartum blood pressure control

Retrospective observational arm

No Intervention group

Description:

The retrospective cohort will include all patients diagnosed with chronic hypertension or pregnancy-induced hypertensive (PIH) disorders at Robert Wood Johnson University Hospital and Cooperman Barnabas Medical Center in the past two years, including those presenting to the Emergency Department or readmitted for hypertensive disorders, during the immediate six weeks postpartum.