Top

Reproductive Health

Published in:

Open Access 01-12-2018 | Study protocol

A comprehensive postpartum follow-up health care program for women with history of preeclampsia: protocol for a mixed methods research

Authors: Mastaneh Kamravamanesh, Shahnaz Kohan, Negin Rezavand, Ziba Farajzadegan

Published in: Reproductive Health | Issue 1/2018

Abstract

Background

Long-term postpartum follow-up is of great importance since women with preeclampsia history are at high risk of upcoming health complications. However, postpartum follow-up rates are poor. According to evidences, preeclampsia is not just a transient health problem; rather it causes short term and long term complications, which affect women’s life for years after delivery. Although it seems the problem is solved by the end of pregnancy, the follow-up of subjects should not be stopped after delivery. Postpartum is the best possible time to provide necessary care to these women who are at the risk of future complications. Due to importance of well-designed follow-up plan for women suffering preeclampsia, this study will carry out to provide a postpartum follow-up health care program for subjected women.

Methods

This study is a qualitative-quantitative mixed sequencing exploratory study that consists of three consecutive phases. In this study, following a qualitative approach, the researcher will explain the needs and strategies related to promoting the health of women with preeclampsia history in the postpartum period. By entering the second phase, the researcher will design a comprehensive follow-up health care program in the postpartum period in which, in addition to using the qualitative study results, related papers and texts will be also used. The proposed program is designed by a panel of experts based on prioritization guidelines. Finally, after passing different stages of program finalizing, its effectiveness on the lifestyle of women with preeclampsia history will be investigated in a semi-experimental study in the third phase of the study.

Discussion

It is expected conducting a mixed method study to design and execute an interventional program to follow up women with preeclampsia history improve their health status and well-being, while reducing their health care costs through prevention in various levels within the current structure of health care services. If this program is effective, it could be included in the postpartum health care guidelines.

Trial registration

IRCT20170927036445N2 Registered 10 March 2018.

Cursino T, Katz L, Coutinho I, Amorim M. Diuretics vs. placebo for postpartum blood pressure control in preeclampsia (DIUPRE): a randomized clinical trial. Reprod Health. 2015;12:66. https://doi.org/10.1186/s12978-015-0057-0.CrossRefPubMedPubMedCentral

World Health Organization. Consultation on improving measurement of the quality of maternal, newborn and child care in health facilities. Ferney Voltaire: World Health Organization andPartnership for Maternal, Newborn and Child Health; 2014.

Evans CS, Gooch L, Flotta D, Lykins D, Powers RW, Landsittel D, et al. Cardiovascular system during the postpartum state in women with a history of preeclampsia. Hypertension. 2011;58(1):57–62. https://doi.org/10.1161/HYPERTENSIONAHA.111.173278.CrossRefPubMedPubMedCentral

Timpka S, Stuart JJ, Tanz LJ, Rimm EB, Franks PW, Rich-Edwards JW. Lifestyle in progression from hypertensive disorders of pregnancy to chronic hypertension in Nurses' health study II: observational cohort study. BMJ. 2017;12(358):j3024. https://doi.org/10.1136/bmj.j3024.CrossRef

Bro Schmidt G, Christensen M, Breth KU. Preeclampsia and later cardiovascular disease - what do national guidelines recommend? Pregnancy Hypertens. 2017;10:14–7. https://doi.org/10.1016/j.preghy.2017.07.139.CrossRefPubMed

Park Y, Cho GJ, Kim LY, Lee TS, Oh MJ, Kim YH. Preeclampsia increases the incidence of postpartum cerebrovascular disease in Korean population. J Korean Med Sci. 2018;5; 33(6):e35. https://doi.org/10.3346/jkms.2018.33.e35.CrossRef

Barry DR, Utzschneider KM, Tong J, Gaba K, Leotta DF, Brunzell JD, et al. Intraabdominal fat, insulin sensitivity, and cardiovascular risk factors in postpartum women with a history of preeclampsia. Am J Obstat Gynecol. 2015;213(1):104.el–11. https://doi.org/10.1016/j.ajog.2015.05.040.CrossRef

Firoz T, Melnik T. Postpartum evaluation and long term implications. Best Practice & Research Clinical Obstetrics and Gynecology. 2011;25:549–61.CrossRef

Janmohamed R, Montgomery-Fajic E, Sia W, Germaine D, Wilkie J, Khurana R, et al. Cardiovascular risk reduction and weight Management at a Hospital-Based Postpartum Preeclampsia Clinic. J Obstet Gynaecol Can. 2015;37(4):330–7.CrossRefPubMed

10.

Stekkinger E, Zandstra M, Peeters LLH, Spaanderman MEA. Early-onset preeclampsia and the prevalence of postpartum metabolic syndrome. Obstet Gynecol. 2009;114(5):1076–84.CrossRefPubMed

11.

Rich-Edwards JW, McElrath TF, Karumanchi A, Seely EW. Breathing life into the lifecourse approach: pregnancy history and cardiovascular disease in women. Hypertension. 2010;56(3):331–4. https://doi.org/10.1161/HYPERTENSIONAHA.110.156810.CrossRefPubMedPubMedCentral

12.

Seely EW, Tsigas E, Rich-Edwards JW. Preeclampsia and future cardiovascular disease in women: how good are the data and how can we manage our patients? Seminars in P E R INATOLOGY. 2015;39:276–83.

13.

Skurnik G, Roche AT, Stuart JJ, Rich-Edwards J, Tsigas E, Levkoff SE, et al. Improving the postpartum care of women with a recent history of preeclampsia: a focus group study. Hypertens Pregnancy. 2016;35(3):371–81. https://doi.org/10.3109/10641955.2016.1154967.CrossRefPubMedPubMedCentral

14.

Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams’s obstetrics, 24^th.Ed. New York: McGraw–Hill Education; 2014. p. 768–70.

15.

Ghossein – Doha C, Peeters L, Van Heijster S, Van Kuijk S, Spann J, Delhaas T, et al. Hypertension after preeclampsia is preceded by changes in cardiac structure and function. Hypertension. 2013;6(2):382–90. https://doi.org/10.1161/HYPERTENSIONAHA.113.01319.16.CrossRef

16.

Berks D, Hoedjes M, Raat H, Duvekot JJ, Steegers EA, Habbema JD. Risk of cardiovascular disease after preeclampsia and the effect of lifestyle interventions: a literature – based study. BJOG. 2013;120(8):924–31. https://doi.org/10.1111/1471-0528.12191.CrossRefPubMed

17.

Seely EW, Rich-Edwards J, Lui J, Nicklas JM, Saxena A, Tsigas E, et al. Risk of future cardiovascular disease in women with prior preeclampsia: a focus group study. BMC Pregnancy and Childbirth. 2013;13:240.CrossRefPubMedPubMedCentral

18.

Dekker G. Hypertension. In: James DK, Steer PJ, Weiner CP, Gonik B, Crowther F, Robson S, editors. High risk pregnancy. Management options. 4^th ed. Philadelphia: Saunders; 2011. p. 626–7.

19.

Paauw ND, Luijken K, Franx A, Verhaar MC, Lely AT. Long – term renal and cardiovascular risk after preeclampsia: toward screening and prevention. Clin Sci (Lond). 2016;1;130(4):239–46.CrossRef

20.

Behrens I, Basit S, Lvkke JA, Ranthe MF, Wohlfahrt J, Bundgaard H, et al. Association between hypertensive disorders of pregnancy and later risk of cardiomyopathy. JAMA. 2016;8:315(10):1026–33. https://doi.org/10.1001/jama.2016.1869.CrossRefPubMed

21.

Silva Mde L, Galvao AC, Souza NL, Azevedo GD, Jeronimo SM, Araujo AC. Women with cardiovascular risk after preeclampsia: is there follow – up within the unified health system in Brazil? Rev Lat Am Enfermagem. 2014;22(1):93–9. https://doi.org/10.1590/0104-1169.3197.2389.CrossRefPubMed

22.

Enkhmaa D, Wall D, Mehta PK, Stuart JJ, Rich-Edwards JW, Merz CN, et al. Preeclampsia and vascular function: a window to future cardiovascular disease risk. J Women's Health (Larchmt). 2016;25(3):284–91. https://doi.org/10.1089/jwh.2015.5414.CrossRef

23.

Aykas F, Solka Y, Erden A, Bulut K, Dogan S, Sarli B, et al. Persistence of cardiovascular risk factors in women with previous preeclampsia: a long-term follow-up study. J Investig Med. 2015;63(4):641–5. https://doi.org/10.1097/JIM.0000000000000189.CrossRefPubMed

24.

Schaaf JM, Bruinse HW, Leeuw-Harmsen LVD, Groeneveld E, Koopman C, Franx A. Etal. Reproductive outcome after early-onset pre-eclampsia. Hum Reprod. 2011;26(2):391–7. https://doi.org/10.1093/humrep/deq324.CrossRefPubMed

25.

Hoedjes M, Berks D, Vogel I, Franx A, Duvekot JJ, Steegers EA, et al. Poor health-related quality of life after severe preeclampsia. Birth. 2011;38(3):246–55.CrossRefPubMed

26.

Stern C, Trapp EM, Mautner E, Deutsch M, Lang U, Cervar-Zivkovic M. The impact of severe preeclampsia on maternal quality of life. Qual Life Res. 2014;23(3):1019–26.CrossRefPubMed

27.

Hoedjes M, Berks D, Vogel I, Franx A, Visser W, Duvekot JJ, et al. Effect of postpartum lifestyle interventions on weight loss, smoking cessation, and prevention of smoking relapse: a systematic review. Obstetrical & Gynecological Survey. 2010;65(10):631–52.CrossRef

28.

Prick BW, Bijlenga D, Jansen AJG, Boers KE, Scherjon SA, Koopmans CM, et al. Determinants of health-related quality of life in the postpartum period after obstetric complications. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2015;185:88–95.CrossRef

29.

Spaan J, Peeters L, Spaanderman M, Brown M. Cardiovascular management after a hypertensive disorder of pregnancy. Hypertention. 2012;60(6):1368–73.CrossRef

30.

Heidrich MB, Wenzel D, Von Kaisenberg CS, Schippert C, Von Versen-Höynck FM. Preeclampsia and long-term risk of cardiovascular disease: what do obstetrician-gynecologists know? BMC Pregnancy Childbirth. 2013;13:61. https://doi.org/10.1186/1471-2393-13-61.CrossRefPubMedPubMedCentral

31.

Brown MC, Bell R, Collins C, Waring G, Robson SC, Waugh J, et al. Women’s perception of future risk following pregnancies complicated by preeclampsia. Hypertens Pregnancy. 2013;32(1):60–73. https://doi.org/10.3109/10641955.2012.704108.CrossRefPubMed

32.

Zoet GA. Determinants of future cardiovascular health in women with a history of preeclampsia. Maturitas. 2015;82:153–61.CrossRefPubMed

33.

Cusimano MC, Pudwell J, Roddy M, Jane Cho C-K, Smith GN. The maternal health clinic: an initiative for cardiovascular risk identification in women with pregnancy-related complications. Am J Obstet Gynecol. 2014;210(5):438.e1–9.CrossRef

34.

Verbeek AL, Verbeek AJ. Timely assessment of cardiovascular risk after preeclampsia. Women’s Health. 2014;10(6):557–9.CrossRefPubMed

35.

Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24:105–12. doi.org/10.1016/j.nedt.2003.10.001.CrossRefPubMed

36.

Polit DF, Beck CT. Essentials of nursing research. In: Appraising evidence for nursing practice. Ninth Edition. Philadelphia: Wolters Kluwer/Lippincott/Williams & Wilkins Health; 2018. p. 295–6.

37.

Kaze FF, Njukeng FA, Kengne AP, Ashuntantang G, Mbu R, Halle MP, et al. Postpartum trend in blood pressure levels, renal function and proteinuria in women with sever preeclampsia and eclampsia in sub-Saharan Africa: a 6-months cohort study. BMC Pregnancy childbirth. 2014;9(14):134. https://doi.org/10.1186/1471-2393-14-134.CrossRef

38.

Wu P, Haththotuwa R, Kwok CS, Babu A, Kotronias RA, Rushton C, et al. Preeclampsia and future cardiovascular health: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2017;10(2) https://doi.org/10.1161/CIRCOUTCOMES.116.003497.

39.

Mito A, Arata N, Sakamoto N, Miyakoshi K, Waguri M, Osamura A, et al. Present status of clinical care for postpartum patients with hypertensive disorders of pregnancy in Japan: findings from a nationwide questionnaire survey. Hypertens Pregnancy. 2015;34(2):209–20. https://doi.org/10.3109/10641955.2014.1001902.CrossRefPubMed

40.

Blaauw J, Souwer ET, Coffeng SM, Smit AJ, Van Doormaal JJ, Faas MM, et al. Follow up of intima-media thickness after severe early-onset preeclampsia. Acta Obstet Gynecol Scand. 2014;93(12):1309–16. https://doi.org/10.1111/aogs.12499.CrossRefPubMed

41.

Levine LD, Nkonde-Price C, Limaye M, Srinvas SK. Factors associated with postpartum follow-up and persistent hypertension among women with severe preeclampsia. J Perinatol. 2016;36(12):1079–82. https://doi.org/10.1038/jp.2016.137.CrossRefPubMedPubMedCentral

42.

Spratling PM, Pryor ER, Moneyham LD, Hodges AL, White-Williams CL, Martin JN. Effect of an educational intervention on cardiovascular disease risk perception among women with preeclampsia. J Obstet Gynecol Neonatal Nurs(JOGNN). 2014;43(2):179–89. https://doi.org/10.1111/1552-6909.12296.CrossRef

43.

Van Kesteren F, Visser S, Hermes W, Teunissen PW, Franx A, Van Pampus MG, et al. Counseling and management of cardiovascular risk factors after preeclampsia. Hypertens Pregnancy. 2016;35(1):55–61. https://doi.org/10.3109/10641955.2015.1100311.CrossRefPubMed

44.

Hoedjes M, Berks D, Vogel I, Duvekot JJ, Oenema A, Franx A, et al. Preferences for postpartum lifestyle counseling among women sharing an increased cardiovascular and metabolic risk: a focus group study. Hypertens pregnancy. 2011;30(1):83–92. https://doi.org/10.3109/10641955.2010.486459.CrossRefPubMed

Title: A comprehensive postpartum follow-up health care program for women with history of preeclampsia: protocol for a mixed methods research
Authors: Mastaneh Kamravamanesh
Shahnaz Kohan
Negin Rezavand
Ziba Farajzadegan
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI: https://doi.org/10.1186/s12978-018-0521-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A comprehensive postpartum follow-up health care program for women with history of preeclampsia: protocol for a mixed methods research

Abstract

Background

Methods

Discussion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Discussion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2018

Health and sustainable development; strengthening peri-operative care in low income countries to improve maternal and neonatal outcomes

Analysis of induced abortion-related complications in women admitted to the Kinshasa reference general hospital: a tertiary health facility, Democratic Republic of the Congo

Inequities in maternal health services utilization in Ethiopia 2000–2016: magnitude, trends, and determinants

Effectiveness of respectful care policies for women using routine intrapartum services: a systematic review

Trends in adolescent first births in five countries in Latin America and the Caribbean: disaggregated data from demographic and health surveys

Birth preparedness and complication readiness among pregnant women in Ethiopia: a systematic review and Meta-analysis