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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: 10.1097/AOG.0000000000002115
Contents: Consensus Statement

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.

Severe maternal morbidity from hypertension may be prevented through the implementation of a bundle of evidence-based, straightforward actions.

Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York; University of Mississippi, Jackson, Mississippi; Baptist Healthcare Lexington, Lexington, Kentucky; Marian Regional Medical Center, Santa Maria, California; Dignity Health, San Francisco, California; Stanford University, Stanford, California; the Society for Obstetric Anesthesia and Perinatology, Milwaukee, Wisconsin; the University of Chicago, Chicago, Illinois; the American Academy of Family Physicians, Leawood, Kansas; the California Maternal Quality Care Collaborative, Stanford, California; the Association of Women's Health, Obstetric and Neonatal Nurses, Washington, DC; the American College of Nurse-Midwives, Silver Spring, Maryland; Frontier Nursing University, Hyden, Kentucky; the Preeclampsia Foundation, Melbourne, Florida; the American College of Obstetricians and Gynecologists, Washington, DC; the Society for Maternal-Fetal Medicine; Washington, DC; and the University of North Carolina, Chapel Hill, North Carolina.

Corresponding author: Peter S. Bernstein, MD, MPH, Montefiore Medical Center, Jack D. Weiler Hospital, 1825 Eastchester Road, Bronx, NY 10461; email:

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

This article is being published concurrently in the August 2017 issue (Vol. 125, No. 2) of Anesthesia & Analgesia, 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.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.