The goal of this study is to address the significant morbidity associated with preeclampsia diagnosed after delivery. All participants will undergo biomarker evaluation with soluble fms-like tyrosine kinase-1 and placental growth factor (sFlt-1/PlGF) ratio testing before delivery to assess the predictive ability of these biomarkers with new-onset postpartum preeclampsia. High-risk participants will be randomized to a bundle of care strategies aimed at early detection and management of postpartum preeclampsia.
Pregnant patients ≥ 36 weeks gestation without major fetal anomalies
Age ≥ 18 years
Admitted for labor at Dhulikhel Hospital, or intend to deliver at Dhulikhel Hospital
At risk for preeclampsia, using the Clinical Risk Assessment for Preeclampsia according to ACOG and USPSTF
Antenatal hypertensive disorder of pregnancy diagnosis, including gestational hypertension, preeclampsia, eclampsia, or HELLP syndrome, according to ACOG guidelines
Chronic hypertension, according to ACOG guidelines
Known allergy or contraindication to nifedipine
Inability or unwillingness to provide informed consent
Medical College of Wisconsin
Lead sponsor
Dhulikhel Hospital
Collaborator