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The following is a summary of “Incorporation of Mean Arterial Pressure in Clinical Practice Using Quality Improvement Initiative,” published in the October 2024 issue of Obstetrics and Gynecology by Ansari et al.    

Mean arterial pressure (MAP) measurement during pregnancy can identify individuals at higher risk of developing preeclampsia (PE), allowing for timely preventive measures to improve outcomes.  

Researchers conducted a prospective study to assess the impact of a quality improvement (QI) initiative on increasing the practice of MAP measurement in antenatal care.  

The QI team implemented multiple Plan-Do-Study-Act (PDSA) cycles, evaluating MAP measurement rates every 2 weeks as a process measure. The outcome measure was the proportion of patients at high risk of PE started on aspirin based on MAP results. Maternal risk factors were used to classify risk levels (OR 7.2, CI 1.43–36.50). Pregnancy outcomes were compared for low- and high-risk groups.  

The results showed 360 patients during antenatal, the rate of MAP measurement increased from 0% to 90% by the end of the study with successive PDSA cycles. Of these patients, 120 (33.3%) were classified as high-risk for PE based on maternal risk factors (OR 7.2, CI 1.43–36.50). The test demonstrated a sensitivity of 75.0%, specificity of 70.4%, positive predictive value (PPV) of 5.7%, and negative predictive value (NPV) of 99.2%. Aspirin was initiated in 14 of the 120 patients at high risk (11.7%), while PE occurred in 6 of 106 (7.6%) patients at high risk who were not started on aspirin.  

They concluded that incorporating MAP measurement into routine antenatal practice was feasible in high-volume public hospitals using Point of Care Quality Improvement (POCQI) methods, enhancing early identification of patients at risk for PE.  

Source: link.springer.com/article/10.1007/s13224-024-02059-4