Increase in the number of patients diagnosed using the new classification of hypertensive disorders of pregnancy in Japan

Mayama, Michinori; Morikawa, Mamoru; Umazume, Takeshi; Nakagawa, Kinuko; Hosokawa, Ami; Yamaguchi, Masahiro; Chiba, Kentaro; Kawaguchi, Satoshi; Watari, Hidemichi

doi:10.1111/jog.13955

Cited by 5 publications

(4 citation statements)

References 19 publications

(59 reference statements)

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“…Preeclampsia is a heterogeneous, multiorgan disorder affecting 2-5% of pregnancies worldwide and at least 2.7% of singleton pregnancies in Japan [1][2][3][4][5][6]. The condition is associated with significant maternal and fetal mortality, with hypertensive disorders of pregnancy accounting for~14% of maternal deaths globally [7].…”

Section: Introductionmentioning

confidence: 99%

Short-term prediction of preeclampsia using the sFlt-1/PlGF ratio: a subanalysis of pregnant Japanese women from the PROGNOSIS Asia study

et al. 2021

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Two prospective multicenter studies demonstrated that a soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio cutoff of ≤38 can rule out preeclampsia within 1 week with a negative predictive value (NPV) of 99.3% (PROGNOSIS) and 98.6% (PROGNOSIS Asia). We report a subanalysis of the Japanese cohort from the PROGNOSIS Asia study. Pregnant women with suspected preeclampsia between gestational weeks 18 + 0 days and 36 + 6 days were enrolled at eight Japanese sites. Primary objectives: Assess the performance of the Elecsys® sFlt-1/PlGF ratio cutoff ≤38 to rule out preeclampsia within 1 week and of the cutoff >38 to rule in preeclampsia within 4 weeks. Key secondary objectives: Prediction of maternal and fetal adverse outcomes (MAOs/FAOs) and their relationship with duration of pregnancy. Of 192 women enrolled, 180 (93.8%)/175 (91.1%) were evaluable for primary/combined endpoint analyses. Overall preeclampsia prevalence was 13.3%. A sFlt-1/PlGF ratio of ≤38 provided an NPV of 100% (95% confidence interval [CI], 97.5–100) for ruling out preeclampsia within 1 week, and a ratio of >38 provided a positive predictive value of 32.4% (95% CI, 18.0–49.8) for ruling in preeclampsia within 4 weeks. The area under the curve for the prediction of preeclampsia/maternal/fetal adverse outcomes within 1 week was 94.2% (95% CI, 89.3–97.8). After adjusting for gestational age and final preeclampsia status, Cox regression indicated a 2.8-fold greater risk of imminent delivery for women with a sFlt-1/PlGF ratio >38 versus ≤38. This subanalysis of Japanese women with suspicion of preeclampsia showed high predictive value for a Elecsys sFlt-1/PlGF ratio cutoff of 38 for short-term prediction of preeclampsia.

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Section: Introductionmentioning

confidence: 99%

Short-term prediction of preeclampsia using the sFlt-1/PlGF ratio: a subanalysis of pregnant Japanese women from the PROGNOSIS Asia study

et al. 2021

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Section: Introductionmentioning

confidence: 99%

Hypertension in Pregnant Females Promotes Thrombocytopenia

Naz,

Bhutto,

Fatima

et al. 2023

PJMHS

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Objective: To determine how often pregnant hypertensive women get thrombocytopenia during the pregnancy. Study Design: Retrospective study Place and Duration: People university of Medical and Health Sciences for Women Nawabshah. January 2022 to December 2022. Methods: Total 63 pregnant females were presented. All the presented females had pregnancy induced hypertension with age group 18-46 years. All cases included platelet estimate, and thrombocytopenia was diagnosed in individuals with a reported platelet count of less than 1,50,000/cumm. All data were analyzed with SPSS 24.0. Results: Pregnant females had mean age 28.6±4.35 years and had mean BMI 26.4±3.29 kg/m2. Frequency of primigravida was 27 (42.9%) and 36 (57.1%) cases were multi-gravida. Majority of the patients 55 (87.3%) had blood pressure 140-160/90-110 mmHg and 8 (12.7%) cases had Bp > 160/110 mmHg. Frequency of thrombocytopenia was found in 17 (26.98%) cases. Among 17 cases of thrombocytopenia mild PIH was found in 3 cases, moderate in 5 cases and 8 cases had severe PIH. Conclusion: In particular, in third-trimester hypertensive pregnant women, gestational thrombocytopenia (GT) is recognized as a primary cause of thrombocytopenia. For those women, careful monitoring both during and after pregnancy is advised. Keywords: Thrombocytopenia, Gestational hypertension, Pregnancy

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“…Therefore, the discrepancy in PC cut-off values between the two major guidelines makes it difficult to compare studies based on these different guidelines. Actually, a sign of maternal organ damage, including thrombocytopenia (< 150 × 10 9 /L), was included in the criteria of classification of HDP in May 2018 in Japan and it increased the number of women who were diagnosed with pre-eclampsia [6]. To assess whether mild thrombocytopenia reflects maternal organ damage in patients with pre-eclampsia, we examined the impact of mild thrombocytopenia on the severity of preeclampsia and perinatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study

Mayama

Morikawa

Yamada

et al. 2021

BMC Pregnancy Childbirth

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Background Currently, there is a disagreement between guidelines regarding platelet count cut-off values as a sign of maternal organ damage in pre-eclampsia; the American College of Obstetricians and Gynecologists guidelines state a cut-off value of < 100 × 109/L; however, the International Society for the Study of Hypertension in Pregnancy guidelines specify a cut-off of < 150 × 109/L. We evaluated the effect of mild thrombocytopenia: platelet count < 150 × 109/L and ≥ 100 × 109/L on clinical features of pre-eclampsia to examine whether mild thrombocytopenia reflects maternal organ damage in pre-eclampsia. Methods A total of 264 women were enrolled in this study. Participants were divided into three groups based on platelet count levels at delivery: normal, ≥ 150 × 109/L; mild thrombocytopenia, < 150 × 109/L and ≥ 100 × 109/L; and severe thrombocytopenia, < 100 × 109/L. Risk of severe hypertension, utero-placental dysfunction, maternal organ damage, preterm delivery, and neonatal intensive care unit admission were analyzed based on platelet count levels. Estimated relative risk was calculated with a Poisson regression analysis with a robust error. Results Platelet counts indicated normal levels in 189 patients, mild thrombocytopenia in 51 patients, and severe thrombocytopenia in 24 patients. The estimated relative risks of severe thrombocytopenia were 4.46 [95 % confidence interval, 2.59–7.68] for maternal organ damage except for thrombocytopenia, 1.61 [1.06–2.45] for preterm delivery < 34 gestational weeks, and 1.35 [1.06–1.73] for neonatal intensive care unit admission. On the other hand, the estimated relative risks of mild thrombocytopenia were 0.97 [0.41–2.26] for maternal organ damage except for thrombocytopenia, 0.91 [0.62–1.35] for preterm delivery < 34 gestational weeks, and 0.97 [0.76–1.24] for neonatal intensive care unit admission. Conclusions Mild thrombocytopenia was not associated with severe features of pre-eclampsia and would not be suitable as a sign of maternal organ damage.

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Increase in the number of patients diagnosed using the new classification of hypertensive disorders of pregnancy in Japan

Cited by 5 publications

References 19 publications

Short-term prediction of preeclampsia using the sFlt-1/PlGF ratio: a subanalysis of pregnant Japanese women from the PROGNOSIS Asia study

Short-term prediction of preeclampsia using the sFlt-1/PlGF ratio: a subanalysis of pregnant Japanese women from the PROGNOSIS Asia study

Hypertension in Pregnant Females Promotes Thrombocytopenia

Mild thrombocytopenia indicating maternal organ damage in pre‐eclampsia: a cross‐sectional study

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