The Center for Peripartum Optimization

Completed

• Conditions: High Risk Pregnancy; Obstetric Complication; Multidisciplinary Communication; Communication
• Interventions: Other: Seen in clinic

• Registration Number: NCT03522909
• Lead Sponsor: Johns Hopkins University

Brief Summary

In January 2017 investigators started a Center for Peripartum Optimization (CPO) with the aim of optimizing a patient's clinical status in an outpatient setting to minimize unnecessary laboratory tests and studies, costly inpatient consultations, the likelihood of post-surgical adverse events, escalations in level of care, inpatient admissions and readmissions. This research project seeks to evaluate the impact of this innovative concept on patient outcomes during the last 12 months. Investigators will accomplish this by collecting retrospective data from patients' electronic medical records in the intervention group and comparing it to data gathered from a controlled group of patients with similar comorbidities but who were not evaluated at the CPO clinic.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-01
• Primary Completion: 2018-01
• Study First Submitted: 2018-05-01
• Study First Submitted QC: 2018-05-01
• Study First Posted: 2018-05-11
• Status Verified: 2020-07
• Study Completion: 2020-12
• Last Update Submitted: 2021-09-09
• Last Update Posted: 2021-09-13

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 250

Inclusion Criteria

• Records of all female, obstetric patients of child-bearing age who were evaluated in the Center for Peripartum Optimization during the period between January 2017 and January 2018.
• Controlled group will include parturients with match high risk comorbidities or history of nonobstetric surgery during pregnancy who delivered at Johns Hopkins Hospital (JHH) during July 1, 2016 - Dec 31, 2016
• Patients with any one or more of these high risk comorbidities:
• Complex spine pathologies (Scoliosis, vertebral fusion, disc disease, spinal canal defects, neuropathies, and nerve disease, etc.)
• Neurological pathology (Cerebral ischemia, tumor, increased intracranial pressure, cerebral vascular disease, etc.)
• Cardiac disease (Congenital, valvular, pulmonary hypertension, cardiomyopathy, ischemic disease, arrhythmia, etc.)
• Pulmonary disease (History of pulmonary embolism, interstitial lung disease, severe asthma, cancer, etc.)
• Morbid Obesity (Obstructive Sleep Apnea, equipment considerations)
• Hematologic Disorders (Thrombophilias, coagulopathies, patients on anticoagulation)
• Cancer
• Abnormal placentation (Previa, accreta / increta / percreta)
• Anesthetic concerns (Airway abnormalities, history of adverse anesthetic reactions or experiences (i.e. recall, anaphylaxis))
• Fetal therapy patients requiring specialized management (Ex utero intrapartum treatment (EXIT), Fetoscopic endotracheal occlusion (FETO), Twin-to-twin transfusion syndrome (TTTS), Percutaneous Umbilical Blood Sampling (PUBS), etc.)
• Chronic Pain

Exclusion Criteria

• Records of CPO participating parturients outside the specified timeframe.
• Records of obstetric patients of child-bearing age without high-risk comorbid conditions described in inclusion criteria.
• Records of patients seen in CPO clinic that did not deliver at our institution

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Study	Seen in clinic	We will be reviewing records of parturients seen at Johns Hopkins Hospital in the Center for Peripartum Optimization (CPO) clinic between January 2017 to January 2018

Primary Outcome Measures

Name	Time	Method
Hospital length of stay	1 year	Total days of hospital admission

Secondary Outcome Measures

Name	Time	Method
Number of admissions from outside hospitals	1 year	The total number of admissions to any other hospitals prior to admission or after discharge
Patient satisfaction	1 year	Whether patient was satisfied (yes/no) with treatment course based on survey filled out by patient.
Opioids use	1 year	To determine if patient require opioid use
Cost of outpatient care	1 year	The cost for outpatient care incurred by patient
Cost of inpatient admission	1 year	the entire admission cost of admission during hospital stay
ICU admissions	1 year	Whether patient needed ICU admission or transfer
Neonatal Intensive Care Unit (NICU) admissions	1 year	Number of times a neonate got admitted to the NICU
Hospital readmissions rate	1 year	The number of times a patient got readmitted after discharge

Trial Locations

Locations (1)

Johns Hopkins Hospital; 🇺🇸 Baltimore, Maryland, United States