Follow-up among postpartum patients diagnosed with hypertensive disorders of pregnancy and gestational diabetes mellitus

Hypertensive disorders of pregnancy (HDP), including gestational hypertension, pre-eclampsia, and eclampsia, as well as gestational diabetes mellitus (GDM), are linked to a higher risk of maternal cardiovascular disease (CVD) later in life. Women with HDP have double the risk of developing essential hypertension, a leading cause of heart disease and stroke. Despite these associations, there is limited guidance on optimal screening for CVD risk, treatment initiation, and management in this population.

This quality improvement project evaluated follow-up rates for patients diagnosed with HDP and/or GDM at three key postpartum intervals: 4-8 weeks, 2-12 months, and after one year. A retrospective chart review was conducted for female patients whose family doctors were at Cornerstone Medical Clinic, Saskatoon, and who delivered between January 1 and December 31, 2022. Follow-up rates were 100%, 55%, and 22%, respectively, with a 20% follow-up rate for GDM at 6 weeks postpartum.

The findings highlight the importance of postpartum care for women with HDP and GDM, and the low follow-up rates align with existing literature. A key barrier is the lack of standardized postpartum care, emphasizing the need for consolidated recommendations to improve CVD risk management.