Increasing the Measurement of Mean Arterial Pressure in Pregnant Women During Antenatal Check-Ups

The goal was to increase the measurement of mean arterial pressure (MAP) in pregnant women during antenatal check-ups from 0% to 70% within six months.

A quality improvement (QI) team implemented several Plan-Do-Study-Act (PDSA) cycles. The process measure involved bi-weekly evaluations of MAP measurement improvements, while the outcome measure tracked the percentage of women prescribed aspirin. The pregnancy outcomes of both low-risk and high-risk women were compared.

The outcomes of the study revealed:

The study included a total of 360 pregnant women.

Through iterative PDSA cycles, which focused on addressing knowledge gaps, engaging a multidisciplinary team, involving support staff, and utilizing software, the MAP measurement rate increased from 0% to 90% by the study's conclusion.
Among the participants, 120 out of 360 (33.3%) were classified as high-risk due to maternal risk factors (OR 7.2, CI 1.43–36.50).
The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the assessment were 75.0%, 70.4%, 5.7%, and 99.2%, respectively.
Of the high-risk group, 14 out of 120 (11.7%) were started on aspirin.
Pregnancy complications occurred in 6 out of 106 (7.6%) women who did not receive aspirin.

In summary, the successful integration of MAP measurement into routine clinical practice is achievable in a busy public hospital setting through point-of-care quality improvement (POCQI) initiatives.

Source: Ansari, S., Yadav, R., Jaiswal, N. et al. Incorporation of Mean Arterial Pressure in Clinical Practice Using Quality Improvement Initiative. J Obstet Gynecol India (2024). https://doi.org/10.1007/s13224-024-02059-4

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