The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice

• Published in: Pregnancy hypertension Vol. 27; pp. 148 - 169
• Main Authors: Magee, Laura A, Brown, Mark A., Hall, David R., Gupte, Sanjay, Hennessy, Annemarie, Karumanchi, S. Ananth, Kenny, Louise C., McCarthy, Fergus, Myers, Jenny, Poon, Liona C., Rana, Sarosh, Saito, Shigeru, Staff, Anne Cathrine, Tsigas, Eleni, von Dadelszen, Peter
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2022
• Subjects: Antihypertensive Agents - therapeutic use; Blood Pressure Determination - methods; Exercise; Female; Humans; Hypertension; Maternal; Outcome; Perinatal; Postnatal Care - methods; Pre-eclampsia; Pre-Eclampsia - diagnosis; Pre-Eclampsia - drug therapy; Pre-Eclampsia - prevention & control; Pregnancy; Proteinuria - urine; Risk Factors; Societies, Medical; ABPM; RR; RCT; ART; GPP; HELLP syndrome; NICU; FIGO; BP; QPM; HDP; sFlt-1; HBPM; PrCr; ISSHP; BID; CKD; PlGF; AKI; BMI; WHO; Hypertension; Maternal; OR; MR; ISUOG; Perinatal; Pre-eclampsia; IV; QID; TID; ACR; FGR; Pregnancy; PA; MgSO4; XL; LA; Outcome; QAM
• ISSN: 2210-7789; 2210-7797; 2210-7797
• DOI: 10.1016/j.preghy.2021.09.008

•This updates the 2018 ISSHP guidelines, and feedback is invited (info@isshp.org).•Angiogenic imbalance is uteroplacental dysfunction when definingpre-eclampsia.•Use multivariable models to estimate the risk of developing pre-eclampsia.•Use aspirin from early pregnancy to halve the risk of preterm pre-eclampsia.•Use multivariable models to estimate the risk of pre-eclampsia complications.•Treat hypertension to a target diastolic BP of 85 mmHg, before or after birth. All units managing hypertensive pregnant women should maintain and review uniform departmental management protocols and conduct regular audits of maternal & fetal outcomes. The cause(s) of pre-eclampsia and the optimal clinical management of the hypertensive disorders of pregnancy remain uncertain; therefore, we recommend that every hypertensive pregnant woman be offered an opportunity to participate in research, clinical trials and follow-up studies.