Updated Guidelines Recommend Blood Pressure Checks at Each Prenatal Visit

Lauren Santye, Assistant Editor
Published Online: Tuesday, April 25th, 2017
Pregnant women should undergo routine blood pressure checks at every prenatal visit to screen for preeclampsia, according to recently released guidelines by the US Preventive Services Task Force (USPSTF).
 
“Preeclampsia is one of the most serious health problems affecting pregnant women,” Dr Maureen Phipps, a member of the USPSTF, said in a press release. Because this condition is common and critical, the task force offers 2 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.”
 
The recommendations are published in JAMA and apply to women without a history of preeclampsia or high blood pressure. Separate guidelines released in 2014 advise low-dose aspirin (81 mg/d) as preventive medication after the first 12 weeks of pregnancy in women with a high risk of preeclampsia.
 
Preeclampsia typically develops after 20 weeks of pregnancy and can progress quickly. Furthermore, blood pressure screenings conducted earlier in the pregnancy can reflect normal results for women who end up developing preeclampsia later.
 
In addition to elevated blood pressure, preeclampsia can cause excess protein in the urine; the swelling of the hands, feet, and legs; risk of stroke; seizures; organ failure; and in rare cases, even death. Babies may suffer slower growth in the uterus, low birth weight, and death.
 
Risks for developing preeclampsia include a history of diabetes, kidney disease, lupus, obesity, or rheumatoid arthritis, according to the release.
 
“Beyond that, it is also important to ensure that all health problems are well managed prior to pregnancy, co-author Dana Gosset said in a press release. “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.”
 
By checking blood pressure at each visit, the updated guidelines can help prevent complications for both mothers and babies, said Dr Martha Gulati, 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 in a release. “We will save lives and prevent complications and death in pregnant women with this simple, cost-effective test.”


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