ASK ABOUT PREGNANCY

• In the US, approximately 700 U.S. women die each year from pregnancy-related causes. Approximately one in three pregnancy-related deaths occur one week to one year after delivery. Compared with other racial and ethnic groups, rates of pregnancy-related death are higher in non-Hispanic Black and American Indian/Alaska Native women.1
• In addition to post-partum infection and VTE, underlying causes of pregnancy-related deaths in the pregnant and 12-month postpartum period can also include cardiomyopathy; hypertensive emergencies such as preeclampsia, eclampsia, and stroke; and conditions related to mental health such as suicide and overdose.  Pre-eclampsia/eclampsia can occur up to 6 weeks post-partum and the diagnosis is often overlooked at that time, even knowing that the patient has recently delivered. Patients who develop signs or symptoms of any of these conditions may present for care in urgent care facilities.1
• The U.S. pregnancy related mortality rate for 2021 was 32.9 maternal deaths per 100,000 live births. While rates in low-income countries are as high as 430 maternal deaths in 100,000 live births, the rate in the US is more than ten times the estimated rates of some other high-income countries, including Australia, Austria, Israel, Japan, and Spain which ranged between 2 and 3 deaths per 100,000 live births in 2020.2
• Knowing that a woman is pregnant or within a year postpartum is key
• While sometimes it is obvious, in many cases it is not, and the differential diagnosis in pregnant and postpartum women include life-threatening conditions which might not be considered otherwise. Ask all female patients about this and consider placing posters in the clinic reminding patients to mention this important piece of information, even if they feel it is not related to the reason for their visit.
• Early recognition of a potential problem can be lifesaving
• Women may be seen for acute illnesses, injuries, or symptoms that occur while they may be pregnant or postpartum. As indicated on the attached material, complaints of shortness of breath, headache, chest pain, neurological symptoms, and edema, or proteinuria found on urinalysis have more significance in these patients. Also, blood pressures > 140/90 should immediately be considered abnormal in a pregnant or recent postpartum patient.