Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Guideline: Severe Hypertension During Pregnancy

Obstet Gynecol; ePub 2017 Jul 7; Bernstein, et al

The National Partnership for Maternal Safety, under the guidance of the Council on Patient Safety in Women’s Health Care, has issued a patient safety bundle that provides guidance to coordinate and standardize the care provided to women with severe hypertension during pregnancy and the postpartum period. The safety bundles outline critical clinical practices that should be implemented in every maternity care setting. The hypertension safety bundle is organized into 4 domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. Highlights include:

  • The Readiness domain include 5 elements to prepare health care facilities for the timely management of women who present with hypertensive emergencies during pregnancy:
    • Standardized diagnostic criteria and monitoring and treatment for severe preeclampsia or eclampsia.
    • Unit team education.
    • Process for timely triage of women with hypertension during pregnancy and the postpartum period.
    • Rapid access to medications used for severe hypertension or eclampsia.
    • System plan for escalation, obtaining appropriate consultation, and maternal transport, as needed.

Bundle components may be adapted to meet the resources available in individual facilities, however, standardization within an institution is strongly encouraged.


Bernstein PS, Martin Jr JN, Barton JR, et al. National partnership for maternal safety. Consensus bundle on severe hypertension during pregnancy and the postpartum period. [Published online ahead of print July 7, 2017]. Obstet Gynecol. doi:10.1097/AOG.0000000000002115.