Postpartum care after preeclampsia: Lack of knowledge and inadequate counseling on long-term consequences

Abstract

Preeclampsia has long-term consequences, with an increased risk of cardiovascular disease. Objective To assess womeńs knowledge about preeclampsia (PE) and to what extent the postpartum healthcare provided was aligned with evidence-based guidelines. Methods A cross-sectional study conducted between 2021 and 2022, in two referral maternity hospitals in southeast Brazil. Women diagnosed with PE in the current pregnancy were contacted by weeks after childbirth and interviewed about the length of hospital stay, use of antihypertensive drugs, scheduled visits, place of care, professionals involved in postpartum care, blood pressure monitoring and knowledge about PE. A descriptive analysis was conducted. Results One hundred and twenty-four women with PE were invited to the study, and 100 answered the questionnaire six weeks postpartum, with a response rate of 80 %. Most women were young (aged 20-34 years), predominantly white, multiparous, and had underlying medical conditions. Route of delivery was predominantly cesarean section (75 %), with a high preterm birth rate (75 %). Half of hospital stays lasted 3-5 days. All women were referred to primary care and 49 % had a scheduled visit recommended during the first week postpartum. Around one-third of the women were not using antihypertensive medication 6 weeks postpartum. Main counselling received: maintenance of blood pressure measurements (65 %), management of medications (53 %), follow-up visits (41 %) and lifestyle changes were encouraged (35 %). However, 98 % of the women were unaware of the long-term repercussions of PE and only 35 % felt supported during postpartum medical care. Conclusion Early return to specialized care was lacking and guidance on the long-term risks after preeclampsia was inadequate.

Keywords: Cardiovascular-disease; Hypertension; Knowledge; Postpartum; Preeclampsia; Pregnancy.