(552) Effect of Oral Furosemide Use on Postpartum Readmissions and Blood Pressure Trends

A hospital-wide, quality program aimed to improve postpartum care related to hypertensive disorders of pregnancy (HDP), called STAMPP HTN, was implemented at our institution and remote patient monitoring (RPM) was added to this program. Patients with a diagnosis of preeclampsia or gestational hypertension were started on oral furosemide (PO Lasix) as a prior study demonstrated that a five-day course of Lasix can help improve the time to hypertension resolution. The purpose of the present study was to compare blood pressure (BP) trends and readmissions amongst patients who did and did not receive Lasix.

Study Design: Prospective cohort study of postpartum patients with HDP at the University of Chicago (UCM) between October 2021 and April 2022. Patients were enrolled into RPM program for BP monitoring and started on PO Lasix as standard of care. Data was obtained from the electronic medical record (EMR) for six weeks postpartum. The primary objective was readmission up to six weeks postpartum. The secondary objective was BP trends across six weeks.

Results:

There were 545 total patients in the RPM program during the study period, with 306 consenting to data collection. Of these, 203 eligible patients received PO Lasix who contributed to 6081 BP recordings in 6 weeks. 18.2% of patients who received Lasix were readmitted versus 21.8% of those who did not (p = 0.55).  There was no difference in readmissions for hypertension (15.3% vs 20.0%, p=0.40) or rates of hypertension (BP ≥ 140/90) in the first week postpartum between those who did and did not receive Lasix (43.3% vs 35.4%, p = 0.63). Diastolic blood pressures at the six-week visit were lower in the Lasix group compared to those without (75 [70, 81] vs 81 [76, 97]; p=0.04).

Conclusion:

The addition of Lasix in an already existing postpartum hypertension program did not result in fewer hospital readmissions or better blood pressure control in first week PP although diastolic blood pressures were lower at the six-week visit in patients who received Lasix. Larger studies need to be done to validate real world impact of routine use of Lasix postpartum.