Journal article
Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement
Obstetrical & gynecological survey, Vol.72(9), pp.515-517
09/01/2017
DOI: 10.1097/OGX.0000000000000483
Abstract
Approximately 4% of pregnancies in the United States are affected by preeclampsia, defined as new-onset hypertension (or worsening hypertension in patients with existing hypertension) after 20 weeks' gestation, combined with either new-onset proteinuria or other symptoms involving multiple organ systems. This disorder is associated with poor maternal and fetal outcomes, including maternal mortality, maternal stroke, low birth weight, and stillbirth. African American women are affected by preeclampsia at a higher rate than are white women and also have higher fatality rates related to preeclampsia, which may be due to unequal access to adequate care.
The US Preventative Services Task Force (USPSTF) accounts for both benefits and harms of preventive care services when making recommendations, but does not consider costs of services. After review of screening and diagnostic methods for preeclampsia, and accuracy and potential harms and benefits of those methods, the USPSTF aimed to update its recommendations on screening for preeclampsia.
The USPSTF also reviewed evidence on the benefits and harms of treatment of screen-detected preeclampsia. The USPSTF found dipstick tests have a low accuracy for detecting proteinuria in pregnancy, whereas blood pressure measurements are accurate in screening for preeclampsia. It was found that well-established treatments of preeclampsia can substantially benefit the mother and child because it can reduce the risk of morbidity and mortality. The potential harm of screening and treatment is no greater than small. With moderate certainty, the USPSTF concludes that screening for preeclampsia carries a substantial net benefit and recommends screening for preeclampsia by obtaining blood pressure measurements at each prenatal care visit during pregnancy.
Screening for preeclampsia with blood pressure measurement throughout pregnancy is recommended. To diagnose preeclampsia, the patient must have elevated blood pressure (>= 140/90 mm Hg on 2 occasions 4 hours apart after 20 weeks' gestation) and proteinuria or, in the absence of proteinuria, must have thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or cerebral or visual symptoms. After preeclampsia diagnosis, treatment may consist of antihypertensive medications, close fetal and maternal monitoring, and magnesium sulfate. In women with a high risk of preeclampsia, low-dose aspirin is also recommended as a preventive medication after 12 weeks' gestation.
Details
- Title: Subtitle
- Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement
- Creators
- Kirsten Bibbins-Domingo - University of California, San FranciscoDavid C. Grossman - Kaiser PermanenteSusan J. Curry - University of IowaMichael J. Barry - Harvard UniversityKarina W. Davidson - Columbia UniversityChyke A. Doubeni - Univ Penn, Philadelphia, PA 19104 USAJohn W. Epling - Virginia TechAlex R. Kemper - Duke UniversityAlex H. Krist - Virginia Commonwealth UniversityAnn E. Kurth - Yale UniversityC. Seth Landefeld - University of Alabama at BirminghamCarol M. Mangione - University of California, Los AngelesWilliam R. Phillips - University of WashingtonMaureen G. Phipps - Brown UniversityMichael Silverstein - Boston UniversityMelissa A. Simon - Northwestern UniversityChien-Wen Tseng - University of Hawaii SystemUS Preventive Services Task Force
- Resource Type
- Journal article
- Publication Details
- Obstetrical & gynecological survey, Vol.72(9), pp.515-517
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/OGX.0000000000000483
- ISSN
- 0029-7828
- eISSN
- 1533-9866
- Number of pages
- 3
- Language
- English
- Date published
- 09/01/2017
- Academic Unit
- Health Management and Policy; Community and Behavioral Health
- Record Identifier
- 9984366370802771
Metrics
4 Record Views