Screening for preeclampsia in pregnant women recommended

April 25, 2017, The JAMA Network Journals
Credit: CC0 Public Domain

The U.S. Preventive Services Task Force (USPSTF) recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy. The report appears in the April 25 issue of JAMA.

This is a B recommendation, which in this case indicates that there is moderate certainty that the net benefit is substantial.

Preeclampsia is defined as new-onset hypertension (or, in patients with existing hypertension, worsening hypertension) occurring after 20 weeks of gestation, combined with either new-onset proteinuria (excess protein in the urine) or other signs or symptoms involving multiple organ systems. It is a relatively common hypertensive disorder occurring during pregnancy, affecting approximately four percent of pregnancies in the United States. Preeclampsia can lead to poor health outcomes in both the mother and infant. It is the leading cause of preterm delivery and low birth weight in the United States and may also lead to other serious maternal complications.

To update its 1996 recommendation, the USPSTF reviewed the on the accuracy of and diagnostic tests for , the potential benefits and harms of screening for preeclampsia, the effectiveness of risk prediction tools, and the benefits and harms of of screen-detected preeclampsia.

The USPSTF is an independent, volunteer panel of experts that makes recommendations about the effectiveness of specific preventive care services such as screenings, counseling services, and preventive medications.

Detection

Obtaining blood pressure measurements to screen for preeclampsia could allow for early identification and diagnosis of the condition, resulting in close surveillance and effective treatment to prevent serious complications. The USPSTF has previously established that there is adequate evidence on the accuracy of blood pressure measurements to screen for preeclampsia. The USPSTF found adequate evidence that testing for protein in the urine with a dipstick test has low diagnostic accuracy for detecting proteinuria in pregnancy.

Benefits of Early Detection and Treatment

Preeclampsia is a complex syndrome. It can quickly evolve into a severe disease that can result in serious, even fatal for the mother and infant. The ability to screen for preeclampsia using blood pressure measurements is important to identify and effectively treat this potentially unpredictable and fatal condition. The USPSTF found adequate evidence that the well-established treatments of preeclampsia result in a substantial benefit for the mother and infant by reducing maternal and perinatal morbidity and mortality. The USPSTF found inadequate evidence on the effectiveness of risk prediction tools (e.g., clinical indicators, serum markers) that would support different screening strategies for predicting preeclampsia.

Harms of Early Detection and Treatment

The USPSTF found adequate evidence to bound the potential harms of screening for and treatment of preeclampsia as no greater than small. This assessment was based on the known harms of treatment with antihypertension medications, induced labor, and magnesium sulfate; the likely few harms from screening with blood pressure measurements; and the potential poor maternal and perinatal outcomes resulting from severe untreated preeclampsia and eclampsia. The USPSTF found inadequate evidence on the harms of risk prediction.

Summary

The USPSTF concludes with moderate certainty that screening for preeclampsia in with pressure measurements has a substantial net benefit.

Explore further: USPSTF recommends BP screening for preeclampsia

More information: JAMA (2017). DOI: 10.1001/jama.2017.3439

Related Stories

USPSTF recommends BP screening for preeclampsia

September 28, 2016
(HealthDay)—The U.S. Preventive Services Task Force (USPSTF) concludes that there is a net benefit for preeclampsia screening with blood pressure measurements throughout pregnancy (B recommendation). These findings form ...

Evidence insufficient to screen for celiac disease

March 28, 2017
The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for celiac disease in asymptomatic persons. The report appears ...

Evidence insufficient regarding screening for obstructive sleep apnea

January 24, 2017
The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea in asymptomatic adults (including ...

Evidence insufficient regarding screening for gynecologic conditions with pelvic examination

March 7, 2017
The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, nonpregnant ...

Routine screening for genital herpes infection not recommended

December 20, 2016
The U.S. Preventive Services Task Force (USPSTF) recommends against routine serologic screening (via a blood test) for genital herpes simplex virus infection in asymptomatic adolescents and adults, including those who are ...

Altered immune cells may both contribute to preeclampsia and offer new hope for treatment

April 24, 2017
Though the exact cascade of events leading to preeclampsia is unknown, reduced blood flow to the placenta (placental ischemia) is commonly thought to be a factor that contributes to the development of the pregnancy-related ...

Recommended for you

Early postpartum opioids linked with persistent usage

December 14, 2018
Vanderbilt researchers have published findings indicating that regardless of whether a woman delivers a child by cesarean section or by vaginal birth, if they fill prescriptions for opioid pain medications early in the postpartum ...

Hysterectomy linked to memory deficit in an animal model

December 6, 2018
By age 60, one in three American women have had a hysterectomy. Though hysterectomy is a prevalent and routine surgery, the removal of the uterus before natural menopause might actually be problematic for cognitive processes ...

Obesity intervention needed before pregnancy

December 6, 2018
New research from the University of Adelaide's Robinson Research Institute supports the need for dietary and lifestyle interventions before overweight and obese women become pregnant.

First baby born via uterus transplanted from dead donor

December 5, 2018
In a medical first, a mother who received a uterus transplant from a dead donor gave birth to a healthy baby, researchers reported Wednesday.

Researchers find evidence of prenatal environment tuning genomic imprinting

December 5, 2018
A team of researchers from the U.S., Australia and Denmark has found evidence of the prenatal environment tuning genomic imprinting. In their paper published in Proceedings of the National Academy of Sciences, the group describes ...

RSV study reveals age when infants are most vulnerable to asthma

December 5, 2018
New research suggests a maternal vaccination against RSV should be augmented with active immunisation in a child's first two years to reduce the onset of asthma.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.