Maternal Fetal Medicine in Virginia: Meeting Patients Where They Are
Maternal Fetal Medicine specialist Dr. Rebecca Rieck from University of Virginia School of Medicine focuses on managing hypertension in pregnancy. They offer remote patient monitoring for postpartum hypertension, achieving positive results and reducing hospital visits. The program covers diagnosis of various conditions like preeclampsia and chronic hypertension, with emphasis on patient follow-up and care.
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Presentation Transcript
Meeting Patients Where They are: Maternal Fetal Medicine in Virginia Rebecca Rieck, MD Assistant Professor, Maternal Fetal Medicine University of Virginia School of Medicine
Hypertension in Pregnancy 15% of women have hypertension during pregnancy 80% of women have persistent hypertension after a pregnancy complicated by hypertensive diseases of pregnancy and 14% of women develop severe hypertension after hospital discharge Hypertension is a leading cause of maternal mortality, accounting for 6.3% of maternal deaths between 2017 and 2019 Only 58% of patients have postpartum follow-up Studies suggest that up to 39% of patients have persistent hypertension at 90 days
Remote Patient Monitoring for Postpartum Hypertension All patients with pregnancy complicated by hypertension Patients are enrolled in Locus Telehealth, our partner for remote patient monitoring, and provided with a blood pressure cuff upon hospital discharge Daily blood pressures are logged on the Locus Telehealth portal and reviewed by our nurse coordinator Patients have telemedicine visits with a provider within 72 hours of discharge then as needed based upon shared decision Remote Patient Monitoring typically lasts for 30 days after discharge
Results of Remote Patient Monitoring Diagnosis Preeclampsia Superimposed preeclampsia Chronic hypertension Gestational hypertension HELLP syndrome Eclampsia Comorbidities Obesity Chronic hypertension Fetal growth restriction Pregestational diabetes mellitus 134 (54.5) 71 (28.9) 15 (6.1) 13 (5.3) 8 (3.3) 2 (0.8) 246 patients enrolled between September 2019 and June 2023 Most patients on antihypertensive medication at discharge 50% remained on antihypertensive medication at program end Mean duration of RPM 32.94 days 123 (50) 86 (35) 46 (18.7) 35 (14.2) Gestational diabetes mellitus Multiple gestation Chronic kidney disease 26 (10.6) 13 (5.3) 2 (0.8) Data are presented as mean SD
Hospital Visits for Hypertension after Discharge Hospital Readmissions for Hypertension after Discharge
Broadband Access and Patient Care Solutions only work when patients can access them.
Opportunities for Expansion of High-Risk Obstetric Care in Virginia Postpartum Hypertension Remote Patient Monitoring Access to MFM consultation via telemedicine Development of expanded inpatient MFM consult services
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