All pregnant women should be screened with blood pressure measurements for preeclampsia throughout pregnancy, according to a new draft recommendation from the U.S. Preventive Services Task Force.
“Preeclampsia is a complex syndrome. It can quickly evolve into a severe disease that can result in serious, even fatal health outcomes for the mother and infant,” the USPSTF members wrote in their draft . “The ability to screen for preeclampsia using blood pressure measurements is important in order to identify and effectively treat a potentially unpredictable and fatal condition.”
The USPSTF noted that there is “adequate evidence” that supported the superior accuracy of blood pressure measurements over urinalysis as dipstick tests have “low diagnostic accuracy for proteinuria detection in pregnancy.”The USPSTF concluded “with moderate certainty” that screening for preeclampsia in all pregnant women with blood pressure measurements yields a substantial net benefit for mothers and newborns as there are “likely few harms” from screening with blood pressure measurements. The draft recommendation has a “B” grade, meaning that clinicians are encouraged to offer the service.
The American College of Obstetricians and Gynecologists applauded the USPSTF’s draft, noting that the recommendations align with their current guidance, which recommends that physicians use detailed medical histories to evaluate a patient’s risk for developing preeclampsia. Ob.gyns. already take a woman’s blood pressure at each routine visit, along with measuring weight, uterine size, and the presence of fetal heart activity, ACOG noted.
“Importantly, ACOG has found there are no accurate, predictive tests at this time to determine whether a woman will develop preeclampsia and therefore continues to recommend against other methods for predicting preeclampsia,” ACOG president Thomas Gellhaus, MD, said in a statement . “A detailed medical history and routine blood pressure measurements are the best tools available to alert ob.gyns. of a potential risk.”
In July, ACOG recommended an expanded list of risk factors for preeclampsia that include history of the condition, multifetal gestation, chronic hypertension, diabetes, renal disease, and autoimmune disease.
The USPSTF is accepting public comment on the draft recommendation until Oct. 24, 2016.
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