Rachel G Sinkey1,2, Ashley N Battarbee3,4, Natalie A Bello5, Christopher W Ives6, Suzanne Oparil7, Alan T N Tita3,4. 1. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, 1700 6th Avenue South, 176F Suite 10270, Birmingham, AL, 35249, USA. rsinkey@uabmc.edu. 2. Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA. rsinkey@uabmc.edu. 3. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, 1700 6th Avenue South, 176F Suite 10270, Birmingham, AL, 35249, USA. 4. Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA. 5. Department of Medicine, Division of Cardiology, Columbia College of Physicians and Surgeons, New York, NY, USA. 6. Tinsley Harrison Internal Medicine Residency Program, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. 7. Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
PURPOSE OF REVIEW: Hypertensive disorders of pregnancy (HDP)-gestational hypertension, preeclampsia, and eclampsia-are a leading cause of adverse maternal and perinatal outcomes internationally. Prevention, timely diagnosis, and prompt management can reduce associated morbidity. The purpose of this review is to compare international guidelines pertaining to HDP. RECENT FINDINGS: Fourteen HDP guidelines were compared relative to guidelines for the United States (US) where the authors practice. Aspirin is universally recommended for high-risk women to reduce preeclampsia risk. Recommended dose and gestational age at initiation vary. Diagnoses of chronic hypertension, gestational hypertension, and preeclampsia in pregnant women are similar, although blood pressure (BP) thresholds for antihypertensive medication initiation and treatment targets vary due to the limitations in high-quality evidence. There are differences among international HDP guidelines related to dose and timing of aspirin initiation, thresholds for antihypertensive medication initiation, and BP targets. However, all guidelines acknowledge the significant morbidity associated with HDP and advocate for timely diagnosis and management to reduce associated morbidity and mortality. More research is needed to understand optimal BP thresholds at which to initiate antihypertensive medication regimens and BP targets in pregnancy.
PURPOSE OF REVIEW: Hypertensive disorders of pregnancy (HDP)-gestational hypertension, preeclampsia, and eclampsia-are a leading cause of adverse maternal and perinatal outcomes internationally. Prevention, timely diagnosis, and prompt management can reduce associated morbidity. The purpose of this review is to compare international guidelines pertaining to HDP. RECENT FINDINGS: Fourteen HDP guidelines were compared relative to guidelines for the United States (US) where the authors practice. Aspirin is universally recommended for high-risk women to reduce preeclampsia risk. Recommended dose and gestational age at initiation vary. Diagnoses of chronic hypertension, gestational hypertension, and preeclampsia in pregnant women are similar, although blood pressure (BP) thresholds for antihypertensive medication initiation and treatment targets vary due to the limitations in high-quality evidence. There are differences among international HDP guidelines related to dose and timing of aspirin initiation, thresholds for antihypertensive medication initiation, and BP targets. However, all guidelines acknowledge the significant morbidity associated with HDP and advocate for timely diagnosis and management to reduce associated morbidity and mortality. More research is needed to understand optimal BP thresholds at which to initiate antihypertensive medication regimens and BP targets in pregnancy.
Authors: Natalie A Bello; Jonathan J Woolley; Kirsten Lawrence Cleary; Louise Falzon; Bruce S Alpert; Suzanne Oparil; Gary Cutter; Ronald Wapner; Paul Muntner; Alan T Tita; Daichi Shimbo Journal: Hypertension Date: 2017-12-11 Impact factor: 10.190
Authors: H Stepan; S Kuse-Föhl; W Klockenbusch; W Rath; B Schauf; T Walther; D Schlembach Journal: Geburtshilfe Frauenheilkd Date: 2015-09 Impact factor: 2.915
Authors: M V B Malachias; C E P Figueiredo; N Sass; I C Antonello; M R Torloni; M R F L Bortolotto Journal: Arq Bras Cardiol Date: 2016-09 Impact factor: 2.000
Authors: Tao Xiong; Yi Mu; Juan Liang; Jun Zhu; Xiaohong Li; Jinke Li; Zheng Liu; Yi Qu; Yanping Wang; Dezhi Mu Journal: Bull World Health Organ Date: 2018-06-12 Impact factor: 9.408
Authors: Alan T Tita; Jeff M Szychowski; Kim Boggess; Lorraine Dugoff; Baha Sibai; Kirsten Lawrence; Brenna L Hughes; Joseph Bell; Kjersti Aagaard; Rodney K Edwards; Kelly Gibson; David M Haas; Lauren Plante; Torri Metz; Brian Casey; Sean Esplin; Sherri Longo; Matthew Hoffman; George R Saade; Kara K Hoppe; Janelle Foroutan; Methodius Tuuli; Michelle Y Owens; Hyagriv N Simhan; Heather Frey; Todd Rosen; Anna Palatnik; Susan Baker; Phyllis August; Uma M Reddy; Wendy Kinzler; Emily Su; Iris Krishna; Nicki Nguyen; Mary E Norton; Daniel Skupski; Yasser Y El-Sayed; Dotum Ogunyemi; Zorina S Galis; Lorie Harper; Namasivayam Ambalavanan; Nancy L Geller; Suzanne Oparil; Gary R Cutter; William W Andrews Journal: N Engl J Med Date: 2022-04-02 Impact factor: 176.079