Obstetricians’ knowledge and practices regarding the management of preeclampsia

Snead, Carrie; Strassberg, Emmie R.; Overcash, Rachael T.; Stark, Lauren; Paglia, Michael J.; Schulkin, Jay; Jelin, Angie C.

doi:10.1080/14767058.2019.1566311

Cited by 11 publications

(6 citation statements)

References 7 publications

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“…Fifty percent of respondents indicated that they initiated aspirin between weeks 12 and 14 for women at elevated risk of preeclampsia, while 24% initiated it prior to 12 weeks. 13 These findings reaffirm the need to further research provider's knowledge and adherence to current guidelines for low-dose aspirin as a prophylactic therapy for preeclampsia risk reduction. Our study will be the first to our knowledge to evaluate prenatal care provider's knowledge of and adherence to shared ACOG, SMFM, and USPSTF guidelines surrounding the use of low-dose aspirin for preeclampsia risk reduction in patients with high risk and moderate risk factors.…”

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confidence: 71%

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Physician's Knowledge and Practices Surrounding Low-Dose Aspirin for Preeclampsia Risk Reduction

2022

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Introduction: Preeclampsia is a leading cause of pregnancy-related deaths. Up to 60% of maternal deaths associated with preeclampsia may be prevented. Clinical trials have shown that low dose aspirin reduces preeclampsia up to 30% among women at increased risk. Since 2014, multiple professional societies and the United States Preventive Services Task Force have released guidelines on the use of low dose aspirin to reduce the risk of preeclampsia. We aimed to evaluate physician knowledge and practices surrounding low dose aspirin for preeclampsia risk reduction. Methods: We distributed an anonymous electronic survey to licensed physicians in the Rio Grande Valley of Texas who provide prenatal care, including general obstetrician-gynecologists, maternal fetal medicine subspecialists, and family medicine physicians. The survey consisted of twenty items assessing demographics, provider practices, and knowledge on use of low dose aspirin for preeclampsia risk reduction. Results: We received 48 surveys for a response rate of 55%. Over 90% of physicians reported recommending low dose aspirin for preeclampsia risk reduction, of which 98% correctly identified the dose. Of physicians recommending aspirin, 83% initiate dosing between 12 and 16 weeks, but only 52% continue it until the day of delivery. Nearly 80% of respondents identified that 1 high-risk factor for preeclampsia is an indication for prophylaxis, but only 56% identified that 2 or more moderate risk factors should prompt aspirin recommendation. Conclusion: Despite clear professional guidelines, physicians demonstrated gaps in knowledge and differences in practices. Enhancing screening tools to assess patient risk of developing preeclampsia and tailored medical education on moderate risk factors are needed to identify patients that may benefit from this intervention. Increasing the use of aspirin in patients at risk is critical given the benefits of low dose aspirin in the reduction of poor maternal and neonatal outcomes related to preeclampsia.

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confidence: 71%

“…Discrepancies between the practices of the obstetricians regarding initiation of aspirin therapy were found. Fifty percent of respondents indicated that they initiated aspirin between weeks 12 and 14 for women at elevated risk of preeclampsia, while 24% initiated it prior to 12 weeks 13 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Physician's Knowledge and Practices Surrounding Low-Dose Aspirin for Preeclampsia Risk Reduction

2022

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“…Current management of PE includes pre‐counselling, prenatal blood pressure screening, patient‐performed home blood pressure monitoring, 5 peripartum blood pressure control, management of complications, timely delivery, and monitoring. 6 Various approaches have been used to reduce the risk of PE in susceptible women, such as calcium supplementation, antioxidant therapy, and antiplatelet therapy, 7 but the only proven treatment for BE is childbirth. Close observation of PE patients without severe symptoms before 37 weeks of gestation is recommended, and delivery is recommended at 37 weeks of gestation.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D may alleviate pre‐eclampsia by modulating the ferroptosis signalling pathway: A hypothesis based on recent literature

Su²,

2023

J Cellular Molecular Medi

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Ferroptosis is a novel form of regulated cell death typically characterized by non‐apoptotic, iron‐dependent, and reactive accumulation of oxygen species. Recent studies have found that ferroptosis plays an important role in the pathophysiology of pre‐eclampsia (PE). In order to find potential therapeutic targets for ferroptosis intervention and better prevent the occurrence and progression of PE, the signalling pathways that regulate ferroptosis need to be identified. In this article, we review the role of vitamin D in PE and the role of ferroptosis in PE. Based on recent literature, we propose the scientific hypothesis that vitamin D can alleviate preeclampsia by modulating the ferroptosis signalling pathway. The aim of this review is to understand the regulatory pathways of ferroptosis in PE and to identify potential therapeutic targets.

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“…There is limited data on aspirin prescription practices about preeclampsia, but one study suggests that differences in patient management exists across different provider training levels. 8 The results demonstrated that maternal fetal medicine (MFM) fellowship-trained attending physicians were more likely than residents, fellows, and advanced care providers to prescribe aspirin to patients with chronic hypertension, whereas residents and fellows were more likely to prescribe it for diabetic patients. In addition, the study found discrepancies were present between current management guidelines and provider practice.…”

Section: Introductionmentioning

confidence: 99%

Hypertension in Pregnancy and Preeclampsia: Variation in Clinical Management Strategies Among Obstetric/Gynecologic Provider Type

Smith,

Kim,

Wolff

et al. 2023

Women's Health Reports

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Background: Preeclampsia, a condition in pregnancy characterized by new onset high blood pressure and proteinuria, complicates 2%–8% of pregnancies globally. Early detection, careful monitoring, and treatment of high blood pressure are crucial in preventing mortality related to preeclampsia disorders. There is limited data that examines obstetric/gynecologic (OBGYN) provider-type practices concerning management of hypertensive disorders of pregnancy to reduce early onset preeclampsia (EOP). We assessed the knowledge and practice patterns of OBGYN management to reduce EOP. Methods: We conducted a semistructured survey with OBGYN residents, maternal-fetal medicine fellows, and attending physicians (OBGYN and family medicine) at a single academic medical center to assess the management of hypertensive disorders to EOP. Results: Thirty-one participants (71% residents/fellows 29% attendings) completed the survey. Seventy-eight percent of attendings indicated they discuss blood pressure and preeclampsia with all patients compared to 50% of residents/fellows ( p = 0.31). Eighty-nine percent of attendings reported they are extremely likely to monitor high-risk patients compared to 36% of residents/fellows ( p = 0.07). Conclusion: Attending physicians were more likely to appropriately manage hypertension in women at risk for pregnancy compared to residents/fellows. Further research is needed on monitoring high-risk patients.

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Obstetricians’ knowledge and practices regarding the management of preeclampsia

Cited by 11 publications

References 7 publications

Physician's Knowledge and Practices Surrounding Low-Dose Aspirin for Preeclampsia Risk Reduction

Physician's Knowledge and Practices Surrounding Low-Dose Aspirin for Preeclampsia Risk Reduction

Vitamin D may alleviate pre‐eclampsia by modulating the ferroptosis signalling pathway: A hypothesis based on recent literature

Hypertension in Pregnancy and Preeclampsia: Variation in Clinical Management Strategies Among Obstetric/Gynecologic Provider Type

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