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 Even though many doctors already monitor blood pressure throughout
pregnancy, the U.S. Preventive Services Task Force (USPSTF), a
government-backed panel of independent physicians, is updating its
clinical guidelines for the first time since 1996 to reflect
emerging evidence on the best way to detect preeclampsia.
“The Task Force recognizes the seriousness of this condition, which
can progress quickly and become severe, and we continue to recommend
pregnant women get screened for preeclampsia,” task force member Dr.
Maureen Phipps, a women’s health researcher at Brown University in
Providence, Rhode Island, said by email.
Preeclampsia is a relatively common high blood pressure disorder in
pregnancy, affecting approximately 4 percent of pregnancies in the
U.S., according to the draft Task Force statement.
In addition to elevated blood pressure, women with preeclampsia may
also have excess amounts of protein in their urine, as well as
swelling in the feet, legs and hands.
When it’s undetected or untreated, the condition can lead to serious
complications for both mother and baby.
Women may suffer from stroke, seizures, organ failure and in rare
cases, death. For babies, complications include slower growth inside
the uterus, low birth weight and death.
The condition is sometimes managed with bed rest or medications to
lower blood pressure. If preeclampsia worsens, however, doctors may
need to deliver babies well in advance of their due dates.
The draft recommendations update guidance from 1996 advising doctors
to screen for preeclampsia with a blood pressure test at the first
prenatal visit and then “periodically throughout the remainder of
the pregnancy.”
It’s unlikely that the new guidelines would change the way doctors
approach screening, said Dr. Christopher Zahn, vice president of
practice activities for the American College of Obstetricians and
Gynecologists (ACOG).
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“We have supported blood pressure measurement at every visit,” Zahn
said by email. “The recommendations reinforce our clinical
guidelines.”
What’s less clear is the best way to identify women who don’t have
preeclampsia but may be at risk for developing it.
Risks for preeclampsia include a history of obesity, diabetes,
kidney disease, lupus or rheumatoid arthritis, as well as a mother
or sister who has experienced the condition.
Women who have a high risk of developing preeclampsia may take
low-dose aspirin during pregnancy as a preventive measure, the Task
Force has previously recommended.
The condition can progress quickly, and typically develops after 20
weeks of pregnancy.
Blood pressure screening earlier in pregnancy can show normal
results for women who go on to develop preeclampsia, the Task Force
notes.
“Management of women with preeclampsia varies depending on when in
pregnancy that it develops, as well as the degree of severity,” Zahn
said.
“Milder cases may be managed by close observation, with the
pregnancy continuing, depending again on when in pregnancy it is
diagnosed,” Zahn added. “Severe cases may necessitate preterm
delivery, as well as the use of medications to prevent eclampsia and
to control blood pressure.”
SOURCE: http://bit.ly/2dpo0st United States Preventive Services Task
Force, online September 27, 2016.
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