New definition and classification of “Hypertensive Disorders of Pregnancy (HDP)

Makino, Shintaro; Takeda, Jun; Takeda, Satoru; Watanabe, Kazushi; Matsubara, Keiichi; Nakamoto, Osamu; Ushijima, Junko; Ohkuchi, Akihide; Koide, Keiko; Mimura, Kazuya; Morikawa, Mamoru; Naruse, Katsuhiko; Nohira, Tomoyoshi; Metoki, Hirohito; Kawabata, Ikuno; Takagi, Kenjiro; Yamasaki, Mineo; Ichihara, Atsuhiro; Kimura, Tadashi; Saito, Shigeru; Seki, Hiroko

doi:10.14390/jsshp.hrp2019-010

Cited by 21 publications

(8 citation statements)

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“…In 2004, Japan revised the term “Toxemia of Pregnancy” to “Pregnancy Induced Hypertension,” which was further revised in 2017, to “Hypertensive disorders of Pregnancy,” shortly named HDP, which is consistent with the international classification [ 2 ]. HDP has been classified into four types as follows: preeclampsia, gestational hypertension, superimposed preeclampsia, and chronic hypertension, excluding eclampsia in the previous disease type classification [ 3 ]. HDP occurs in 5% of women and around 10% of primiparous women out of all pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study

Poudel

Kobayashi

Miyashita

et al. 2021

IJERPH

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Hypertension during pregnancy causes a greater risk of adverse birth outcomes worldwide; however, formal evidence of hypertensive disorders during pregnancy (HDP) in Japan is limited. We aimed to understand the association between maternal characteristics, HDP, and birth outcomes. In total, 18,833 mother-infant pairs were enrolled in the Hokkaido study on environment and children’s health, Japan, from 2002 to 2013. Medical records were used to identify hypertensive disorders and birth outcomes, namely, small for gestational age (SGA), SGA at full term (term-SGA), preterm birth (PTB), and low birth weight (LBW). The prevalence of HDP was 1.9%. Similarly, the prevalence of SGA, term-SGA, PTB, and LBW were 7.1%, 6.3%, 7.4%, and 10.3%, respectively. The mothers with HDP had increased odds of giving birth to babies with SGA (2.13; 95% Confidence Interval (CI): 1.57, 2.88), PTB (3.48; 95%CI: 2.68, 4.50), LBW (3.57; 95%CI: 2.83, 4.51) than normotensive pregnancy. Elderly pregnancy, low and high body mass index, active and passive smoking exposure, and alcohol consumption were risk factors for different birth outcomes. Therefore, it is crucial for women of reproductive age and their families to be made aware of these risk factors through physician visits, health education, and various community-based health interventions.

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Section: Introductionmentioning

confidence: 99%

Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study

Poudel

Kobayashi

Miyashita

et al. 2021

IJERPH

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“…13 HDP was defined as hypertension during pregnancy, including preeclampsia, gestational hypertension, superimposed preeclampsia, and chronic hypertension. 14 This study was approved by the Ethics Committee of the University of Miyazaki (approval number O-0401). Gross findings were recorded from the original pathology reports.…”

Section: Methodsmentioning

confidence: 99%

Association between fetal vascular malperfusion and gestational diabetes

Gotō

Sato

Kodama

et al. 2021

J of Obstet and Gynaecol

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Aim: Diabetes mellitus (DM) is a major complication in pregnancy. Placental lesions with DM remain unclear and controversial. Recently, the terms of placental pathological findings, such as maternal and fetal vascular malperfusions (MVM and FVM, respectively) were introduced by the Amsterdam Placental Workshop Group Consensus Statement (APWGCS). FVM cases were classified as the partial obstruction type (global FVM) and the complete obstruction type (segmental FVM). The aim of this study was to clarify the pathological characteristics of the placenta with pregestational DM/gestational DM; GDM according to APWGCS. Methods: We studied the placentas of 182 DM women (27 pregestational DM and 155 GDM) and control placentas of 460 women without DM during 2011-2018. We excluded cases of intrauterine fetal death or multiple pregnancies. We reviewed microscopical findings including, MVM, FVM, chorioamnionitis with the slides according to the APWGCS. Results: Microscopically, the incidence of FVM was significantly higher in GDM patients than control (17% vs. 10%, p = 0.0138), but not significant in pregestational DM (11%, p = 0.7410). Segmental FVM (complete obstruction) was significantly more observed in GDM than control group (5% vs. 0.4%, p = 0.0013). Segmental FVM in GDM showed high incidence of light-for-dates infant (three of seven cases, 43%, p = 0.0288). In addition, several segmental FVM findings (villous stromal-vascular karyorrhexis and stem vessel occlusion) were frequently noted in 2 or 3 points positive of 75 g oral glucose tolerance test than 1 point positive GDM. Conclusion: Our placental findings suggest disorder of carbohydrate metabolism might affect the fetal vascular damage, especially complete fetal vascular obstruction.

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“…Preeclampsia affects several organ systems and occurs in 2–8% [ 11 ] of pregnancies, being defined as high blood pressure (systolic 140 mmHg or higher or diastolic 90 mmHg or higher) with concomitant proteinuria (>0.3 g/24 h) diagnosed after 20 weeks of gestation [ 12 ]. According to the most recent classifications, the diagnosis of preeclampsia can be made when hypertension is present with maternal organ injury or placental insufficiency, even in the absence of proteinuria [ 13 ].…”

Section: Obstetric Complications Preventable By Asamentioning

confidence: 99%

Aspirin Desensitization: Implications for Acetylsalicylic Acid-Sensitive Pregnant Women

2021

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Low-dose acetylsalicylic acid (ASA) is widely used during pregnancy to prevent obstetric complications of placental dysfunction, such as preeclampsia, stillbirth and fetal growth restriction, and obstetric complications in pregnant women with antiphospholipid syndrome. ASA-sensitive pregnant women cannot benefit from the effects of ASA due to the possibility of severe or potentially life-threatening hypersensitivity reactions to ASA. ASA desensitization is a valuable and safe therapeutic option for these women, allowing them to start daily prophylaxis with ASA and prevent pregnancy complications. The authors discuss the recent advances in obstetric conditions preventable by ASA and the management of ASA hypersensitivity in pregnancy, including ASA desensitization. To encourage the implementation of ASA desensitization protocols in ASA-sensitive pregnant women, they also propose a practical approach for use in daily clinical practice.

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New definition and classification of “Hypertensive Disorders of Pregnancy (HDP)

Cited by 21 publications

References 0 publications

Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study

Hypertensive Disorders during Pregnancy (HDP), Maternal Characteristics, and Birth Outcomes among Japanese Women: A Hokkaido Study

Association between fetal vascular malperfusion and gestational diabetes

Aspirin Desensitization: Implications for Acetylsalicylic Acid-Sensitive Pregnant Women

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