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 While many doctors already monitor blood pressure throughout
pregnancy, the U.S. Preventive Services Task Force (USPSTF) updated
its guidelines for the first time since 1996 to stress that
screening at every visit can help doctors catch and treat
preeclampsia before it escalates from a mild problem to a
life-threatening one.
“Preeclampsia is one of the most serious health problems affecting
pregnant women,” task force member Dr. Maureen Phipps, a women’s
health researcher at Brown University in Providence, Rhode Island,
said by email.
“Because this condition is common and critical, the Task Force
offers two separate recommendations to help women lower the risk
associated with preeclampsia - screening for preeclampsia is
recommended for all pregnant women, and women at high risk of
developing the condition can take low-dose aspirin to help prevent
it,” Phipps added by email.
The screening recommendations, published on Tuesday in JAMA, apply
to women without a history of preeclampsia or high blood pressure.
Separate guidelines advise low-dose aspirin after the first 12 weeks
of pregnancy for women with a history of elevated blood pressure.
(http://bit.ly/2oIwP5B)
Preeclampsia 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.
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.
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.
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.
Because the risks of preeclampsia increase with age, women may be
able to lower their chances of developing this complication by
having babies sooner, said Dr. Dana Gossett, an obstetrics and
gynecology researcher at the University of California, San
Francisco, and co-author of an accompanying editorial in JAMA.
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“Beyond that, it is also important to ensure that all health
problems are well managed prior to pregnancy,” Gossett said by
email. “High blood pressure should be under good control, other
diseases like kidney disease or lupus should be well controlled, and
women should try to be close to their ideal body weight prior to
conception.”
Checking blood pressure at every prenatal visit can help prevent
complications for mothers and babies alike, said Dr. Martha Gulati,
chief of cardiology at the University of Arizona College of Medicine
in Phoenix and author of a separate editorial in JAMA Cardiology.
“This is something that should be provided to every woman as part of
preventive care,” Gulati said by email. “We will save lives and
prevent complications and death in pregnant women with this simple,
cost-effective” test that doesn’t take much time.
SOURCE: http://bit.ly/2oGYMKe and http://bit.ly/2peNbnM JAMA, online
April 25, 2017; and http://bit.ly/2q1qDH4 JAMA Cardiology, online
April 25, 2017.
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