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

•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 p...

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Published inPregnancy 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
LanguageEnglish
Published Netherlands Elsevier B.V 01.03.2022
Subjects
Online AccessGet full text
ISSN2210-7789
2210-7797
2210-7797
DOI10.1016/j.preghy.2021.09.008

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Abstract •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.
AbstractList 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.
•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.
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.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.
Author Myers, Jenny
Rana, Sarosh
McCarthy, Fergus
Brown, Mark A.
Karumanchi, S. Ananth
von Dadelszen, Peter
Saito, Shigeru
Staff, Anne Cathrine
Hall, David R.
Hennessy, Annemarie
Gupte, Sanjay
Tsigas, Eleni
Kenny, Louise C.
Poon, Liona C.
Magee, Laura A
Author_xml – sequence: 1
  givenname: Laura A
  surname: Magee
  fullname: Magee, Laura A
  email: laura.a.magee@kcl.ac.uk
  organization: Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, UK
– sequence: 2
  givenname: Mark A.
  surname: Brown
  fullname: Brown, Mark A.
  organization: Departments of Renal Medicine & Medicine, St. George Hospital & University of New South Wales, Sydney, Australia
– sequence: 3
  givenname: David R.
  surname: Hall
  fullname: Hall, David R.
  organization: Department of Obstetrics & Gynaecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
– sequence: 4
  givenname: Sanjay
  surname: Gupte
  fullname: Gupte, Sanjay
  organization: Secretary General, World Organization Gestosis, Gupte Hospital, Pune, India
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  givenname: Annemarie
  surname: Hennessy
  fullname: Hennessy, Annemarie
  organization: School of Medicine, Western Sydney University and South Western Sydney Local Health District, Sydney, Australia
– sequence: 6
  givenname: S. Ananth
  surname: Karumanchi
  fullname: Karumanchi, S. Ananth
  organization: Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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  givenname: Louise C.
  surname: Kenny
  fullname: Kenny, Louise C.
  organization: Faculty of Health & Life Sciences, University of Liverpool and INFANT Centre, Cork University Maternity Hospital, Cork, Ireland
– sequence: 8
  givenname: Fergus
  surname: McCarthy
  fullname: McCarthy, Fergus
  organization: Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
– sequence: 9
  givenname: Jenny
  surname: Myers
  fullname: Myers, Jenny
  organization: Maternal & Fetal Health Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
– sequence: 10
  givenname: Liona C.
  surname: Poon
  fullname: Poon, Liona C.
  organization: Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Chair of Hypertension in Pregnancy Subcommittee FIGO Pregnancy and NCD Committee, Hong Kong
– sequence: 11
  givenname: Sarosh
  surname: Rana
  fullname: Rana, Sarosh
  organization: Department of Obstetrics and Gynecology/Division of Maternal Fetal Medicine, University of Chicago, Chicago, IL, USA
– sequence: 12
  givenname: Shigeru
  surname: Saito
  fullname: Saito, Shigeru
  organization: Department of Obstetrics and Gynecology, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, Japan
– sequence: 13
  givenname: Anne Cathrine
  surname: Staff
  fullname: Staff, Anne Cathrine
  organization: Faculty of Medicine, University of Oslo, and Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
– sequence: 14
  givenname: Eleni
  surname: Tsigas
  fullname: Tsigas, Eleni
  organization: Preeclampsia Foundation, USA
– sequence: 15
  givenname: Peter
  surname: von Dadelszen
  fullname: von Dadelszen, Peter
  organization: Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/35066406$$D View this record in MEDLINE/PubMed
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Snippet •This updates the 2018 ISSHP guidelines, and feedback is invited (info@isshp.org).•Angiogenic imbalance is uteroplacental dysfunction when...
All units managing hypertensive pregnant women should maintain and review uniform departmental management protocols and conduct regular audits of maternal &...
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SubjectTerms 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
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Title The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice
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