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National Partnership for Maternal Safety: Consensus Bundle on Severe Hypertension During Pregnancy and the Postpartum Period

Bernstein, Peter S. MD, MPH*†; Martin, James N. Jr MD; Barton, John R. MD, MS§; Shields, Laurence E. MD‖¶; Druzin, Maurice L. MD#; Scavone, Barbara M. MD**††; Frost, Jennifer MD‡‡; Morton, Christine H. PhD§§; Ruhl, Catherine CNM, MS‖‖; Slager, Joan DNP, CNM¶¶##; Tsigas, Eleni Z.***; Jaffer, Sara MPH†††; Menard, M. Kathryn MD, MPH‡‡‡

doi: 10.1213/ANE.0000000000002304
Obstetric Anesthesiology: Special Article

Complications arising from hypertensive disorders of pregnancy are among the leading causes of preventable severe maternal morbidity and mortality. Timely and appropriate treatment has the potential to significantly reduce hypertension-related complications. To assist health care providers in achieving this goal, this patient safety bundle provides guidance to coordinate and standardize the care provided to women with severe hypertension during pregnancy and the postpartum period. This is one of several patient safety bundles developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women’s Health Care. These safety bundles outline critical clinical practices that should be implemented in every maternity care setting. Similar to other bundles that have been developed and promoted by the Partnership, the hypertension safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. This commentary provides information to assist with bundle implementation.

From the *Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York; University of Mississippi, Jackson, Mississippi; §Maternal-Fetal Medicine, Baptist Healthcare Lexington, Lexington, Kentucky; Maternal Fetal Medicine, Marian Regional Medical Center, Santa Maria, California; Perinatal Safety for Dignity Health, San Francisco, California; #Department of Obstetrics and Gynecology, Stanford University, Stanford, California; **Department of Anesthesia & Critical Care, ††Department of Obstetrics & Gynecology, University of Chicago, Chicago, Illinois; ‡‡Health of the Public and Science Division, American Academy of Family Physicians, Leawood, Kansas; §§California Maternal Quality Care Collaborative, Stanford, California; ‖‖Women's Health Programs, Association of Women's Health, Obstetric and Neonatal Nurses, Washington, DC; ¶¶American College of Nurse-Midwives, Silver Spring, Maryland; ##Frontier Nursing University, Hyden, Kentucky; ***Preeclampsia Foundation, Melbourne, Florida; †††American College of Obstetricians and Gynecologists, Washington, DC; ‡‡‡Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

Accepted for publication May 23, 2017.

Financial Disclosure: The authors did not report any potential conflicts of interest.

This article is being published concurrently in the August 2017 issue (Vol. 130, No. 2) of Obstetrics & Gynecology, the September/October 2017 issue (Vol. 62, No. 5) of Journal of Midwifery & Women’s Health, and the September/October 2017 issue (Vol. 46, No. 5) of Journal of Obstetric, Gynecologic, & Neonatal Nursing.

Each author has indicated that he or she has met the journal’s requirements for authorship.

Corresponding author: Peter S. Bernstein, MD, MPH, Montefiore Medical Center, Jack D. Weiler Hospital, 1825 Eastchester Rd, Bronx, NY 10461. Address e-mail to

© 2017 International Anesthesia Research Society
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