Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement

@article{BibbinsDomingo2017ScreeningFP,
  title={Screening for Preeclampsia: US Preventive Services Task Force Recommendation Statement},
  author={Kirsten Bibbins-Domingo and David C. Grossman and Susan J Curry and Michael J. Barry and Karina W. Davidson and Chyke A Doubeni and John W Epling and Alex R. Kemper and Alex H. Krist and Ann E. Kurth and C. Seth Landefeld and Carol M. Mangione and William R.F. Phillips and Maureen G. Phipps and Michael Silverstein and Melissa A. Simon and Chien-Wen Tseng},
  journal={JAMA},
  year={2017},
  volume={317},
  pages={1661–1667}
}
Importance Preeclampsia affects approximately 4% of pregnancies in the United States. It is the second leading cause of maternal mortality worldwide and may lead to serious maternal complications, including stroke, eclampsia, and organ failure. Adverse perinatal outcomes for the fetus and newborn include intrauterine growth restriction, low birth weight, and stillbirth. Many of the complications associated with preeclampsia lead to early induction of labor or cesarean delivery and subsequent… Expand
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TLDR
The USPSTF concludes with moderate certainty that there is a substantial net benefit of daily low-dose aspirin use to reduce the risk for preeclampsia, preterm birth, small for gestational age/intrauterine growth restriction, and perinatal mortality in pregnant persons at high risk for predisposition. Expand
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TLDR
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Screening for Preeclampsia and the USPSTF Recommendations.
TLDR
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A Critical Review on the Use of Race in Understanding Racial Disparities in Preeclampsia.
TLDR
The racial disparities in preeclampsia incidence, morbidity, and mortality are summarized and the limitations of using race to understand disparities are considered by also examining multiethnic, immigration, and international studies. Expand
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TLDR
Recommendations from published guidelines on gestational hypertension and preeclampsia are reviewed to allow clinicians to adopt effective universal screening, as well as preventive and management strategies with the intention of improving maternal and neonatal outcomes. Expand
Hypertensive Disorders of Pregnancy.
TLDR
In a preterm gestation affected by preeclampsia, expectant management is intended to provide neonatal benefit though it does assume some maternal risk, and management of preterm preeClampsia is guided by close assessment of the status of the pregnant woman and fetus, blood pressure control, and surveillance for any clinical progression to a more severe form of preeclamping. Expand
Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines
TLDR
There are differences among international HDP guidelines related to dose and timing of aspirin initiation, thresholds for antihypertensive medication initiation, and BP targets, however, all guidelines acknowledge the significant morbidity associated with HDP and advocate for timely diagnosis and management to reduce associated morbidity and mortality. Expand
Preeclampsia beyond pregnancy:Long-term consequences for mother and child.
TLDR
It is shown that the consequences of preeclampsia extend far beyond preterm delivery, resulting in increased susceptibility to hypertension and chronic kidney disease, yielding lifelong risk to both individuals. Expand
Individual and Obstetric Risk Factors of Preeclampsia among Singleton Pregnancy in Hospitals of Southern Ethiopia
TLDR
To improve early detection and timely management of preeclampsia, the clinician should give attention to women who have no previous childbirth and whose close relatives had a history of chronic hypertension, as well as working on the protective factor is recommended. Expand
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References

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Screening for Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force
TLDR
There was no clear evidence of the performance, clinical benefits, or harms of any externally validated models for risk prediction, and the clinical performance and impact of risk prediction models could not be extrapolated to relevant patient settings. Expand
Preeclampsia Screening: Evidence Report and Systematic Review for the US Preventive Services Task Force
TLDR
Evidence to estimate benefits and harms of preeclampsia screening and the test performance of different screening approaches over the course of pregnancy was limited and externally validated risk prediction models had limited applicability and lacked calibration and clinical implementation data needed to support routine use. Expand
Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force recommendation statement.
TLDR
The USPSTF recommends the use of low-dose aspirin (81 mg/d) as preventive medication after 12 weeks of gestation in women who are at high risk for preeclampsia. Expand
Pregnancy‐Related Mortality From Preeclampsia and Eclampsia
TLDR
The continuing racial disparity in mortality from preeclampsia and eClampsia emphasizes the need to identify those differences that contribute to excess mortality among black women, and to develop specific interventions to reduce mortality from prenatal care and e clampsia among all women. Expand
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TLDR
Early- and late-onset preeclampsia shares some etiological features, differ with regard to several risk factors, and lead to different outcomes, and should be treated as distinct entities from an etiological and prognostic standpoint. Expand
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TLDR
Clear protocols for early detection and management of hypertension in pregnancy at all levels of health care are required for better maternal as well as perinatal outcome, especially important in the developing countries. Expand
Effect of frequency of prenatal care visits on perinatal outcome among low-risk women. A randomized controlled trial.
TLDR
Good perinatal outcomes and patient satisfaction were maintained when the prenatal visit schedule proposed by the Expert Panel on the Content of Prenatal Care was observed. Expand
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TLDR
Although the placenta plays a crucial role in the development of preeclampsia, the onset, severity, and progression is significantly affected by the maternal response to placentally derived factors and proteins. Expand
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TLDR
The focus of treatment is the 9 months of pregnancy, during which untreated mild-to-moderate hypertension is unlikely to lead to unfavorable long-term maternal outcomes, and antihypertensive agents are mainly used to prevent and treat severe hypertension. Expand
Preeclampsia: Syndrome or Disease?
TLDR
The focus on disease mechanisms underlying the hypertension and proteinuria defining preeclampsia has increased knowledge of the pathophysiology yet the authors lack both therapy and predictors, and the contribution of differing disease phenotypes to the syndrome may explain the inability of biomarker studies to identify all preeClampsia. Expand
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