Preeclampsia Toolkit

Improving Health Care Response to Preeclampsia

 A California Toolkit to Transform Maternity Care


The complete toolkit is available for free download HERE (Including Errata 5/13/14)   (a brief registration is required). 


The Errata is as follows:
-On page 96 and 109 the flowchart "Part 1 of 2: Diagnosis-Evaluation and Treatment of Antepartum and Postpartum Preeclampsia and Eclampsia in the Emergency Department", the following sentence in the OB consult <60 min box of the Diagnosis page should read "If patient’s BP increases to SBP> 160 or DBP >105 then initiate anti-hypertensives and magnesium and notify OB of change in condition if not already present.”

-On page 97 and 110 the table "Part 2 of 2:Treatment-Evaluation and Treatment of Antepartum and Postpartum Preeclampsia and Eclampsia in the Emergency Department", step 2 in the Labetalol as Primary Anti-Hypertensive the second dose of Labetalol is not specified by omission.  It should read "administer 40 mg IV."

For individual sections of the toolkit click below on the link you are interested in, they are available to individuals who have already download the Toolkit.

  1. Care guidelines (in checklist, flowchart or table chart formats) and a compendium of eighteen "best practice" articles

  2. A slide set for professional education

  3. Education and patient information



The CMQCC Preeclampsia Task Force, a multidisciplinary committee of experts co-chaired by Maurice Druzin, MD, Laurence Shields, MD and Nancy Peterson, RNC, PNNP has developed a Toolkit for health care providers who care for women during the prenatal, birth, and postpartum periods. The Toolkit was extensively researched and included peer review and consensus among experts from around the state on best practices for early recognition, diagnosis, treatment and management of preeclampsia. A highlight is the identification of "triggers" or clinical warning signs that require immediate evaluation and communication with the provider, whether in the prenatal clinic, the emergency room, labor & delivery or postpartum.

Hypertensive disorders in pregnancy represent a leading cause of maternal mortality and are responsible for approximately 17% of maternal deaths according to the California Pregnancy Associated Maternal Mortality Review (CA-PAMR), a project of the California Department of Public Health; Maternal, Child and Adolescent Health Division (CDPH/MCAH).  Preeclampsia was the second leading cause of death in 2002-2004, accounting for 17% of the 145 deaths in that time period. All of the deaths due to preeclampsia had some chance of preventability, with nearly half having a good-to-strong chance to alter the outcome.  For every woman who dies, at least 40-50 experience severe complications requiring ICU admission and another 400-500 experience moderate-to-severe complications from preeclampsia or other hypertensive disorders. 

The primary aim of the Toolkit is to guide and support obstetrical providers, clinical staff, hospitals and healthcare organization to develop methods within their facilities for timely recognition and organized, swift response to preeclampsia.

Educational material for pregnant women and their families has been provided by the Preeclampsia Foundation. Hospitals and clinics can order these materials at no cost (shipping and handling only) from the Foundation website:

Free informational webinars about the Toolkit were held and recordings are available for further viewing:**

**If you are unable to download and view the informational webinars, please contact us at

Currently, 25 California hospitals are participating in an 18-month, CMQCC quality improvement collaborative, led by Dr. Laurence Shields, of Dignity Health, to implement the Toolkit.   For more information about the Toolkit, or to learn about CMQCC's Quality Improvement Collaboratives, contact Nancy Peterson at 650-723-4849 or  For other information, or if you have problems with registration or downloading, contact

 Please do not share the Toolkit directly with others (or post on other websites)  As part of our evaluation and to help ensure continued funding for these tools, we need to document the demand for, and interest in, our Toolkits.  Thank you.

Funding for the development of the “Improving the Health Care Response to Preeclampsia” Toolkit is provided by:  Federal Title V block grant funding from the California Department of Public Health; Maternal, Child and Adolescent Health Division (CDPH/MCAH) and Stanford University.