Quality standard

Quality statement 5: Admission to hospital for women with pre-eclampsia

Quality statement 5: Admission to hospital for women with pre-eclampsia

Quality statement

Women with a diagnosis of pre-eclampsia are admitted to hospital and monitored daily.

Rationale

Women with pre-eclampsia should be admitted to hospital to enable their condition to be fully assessed and its progress monitored. High-quality care should include an integrated package of care for women with pre-eclampsia that includes admission and daily monitoring. Some women may need to stay in hospital until after the birth of their baby. For other women, daily monitoring may be possible if pre-eclampsia is stable and if the woman has easy access to monitoring services, and can be readmitted to hospital if her clinical condition deteriorates.

Quality measures

Structure

a) Evidence of local arrangements to ensure that women with a diagnosis of pre-eclampsia are admitted to hospital.

Data source: Local data collection.

b) Evidence of local arrangements for women with pre-eclampsia to receive an integrated package of care that includes daily monitoring of their condition.

Data source: Local data collection.

Process

a) The proportion of women with a diagnosis of pre-eclampsia who are admitted to hospital.

Numerator – the number of women in the denominator who are admitted to hospital when pre-eclampsia is diagnosed.

Denominator – the number of women with pre-eclampsia.

Data source: Local data collection.

b) The proportion of women with pre-eclampsia who are monitored daily.

Numerator – the number of women in the denominator who are monitored daily.

Denominator – the number of women who have pre-eclampsia.

Data source: Local data collection.

What the quality statement means for service providers, healthcare practitioners and commissioners

Service providers ensure that local arrangements are in place for women with a diagnosis of pre-eclampsia to be admitted to hospital and for their condition to be monitored daily.

Healthcare practitioners admit women with a diagnosis of pre-eclampsia to hospital and monitor their condition daily.

Commissioners ensure they commission services that admit women with a diagnosis of pre-eclampsia to hospital and monitor their condition daily.

What the quality statement means for patients, service users and carers

Women with pre-eclampsia (a pregnancy-related rise in blood pressure with protein in the urine that happens in some pregnancies) are admitted to hospital and have their condition monitored every day (while in hospital and at home if they go home before their baby is born).

Source guidance

  • Hypertension in pregnancy (NICE clinical guideline 107) recommendation 1.5.1.2 (key priority for implementation).

Definitions of terms used in this quality statement

Integrated package of care NICE clinical guideline 107 recommends admission to hospital for women with pre-eclampsia as part of an integrated package of care. This covers admission to hospital, treatment, measurement of blood pressure, testing for proteinuria and blood tests.

Pre-eclampsia New hypertension presenting after 20 weeks of pregnancy with significant proteinuria (urinary protein:creatinine ratio greater than 30 mg/mmol or a validated 24‑hour urine collection result greater than 300 mg protein).