Results of a questionnaire survey on blood pressure management in hypertensive disorders of pregnancy in Aomori prefecture, Japan

Abstract

Aim: This study aimed to clarify the appropriate management of hypertensive disorders of pregnancy (HDP) and establish a long-term follow-up system for women with HDP after delivery. We investigated issues relating to HDP management approaches by evaluating blood pressure measurement at the time of medical examination, home blood pressure measurement (HBPM) penetration rate, timing of blood pressure measurement during labor, and follow-up procedures after delivery in women with HDP. Methods: We distributed questionnaire forms on blood pressure management during pregnancy, at delivery, and after delivery to obstetrics and gynecology departments of 52 professional medical institutions in Aomori prefecture, Japan, in 2013. Results: We retrieved completed questionnaires from 52 institutions and analyzed responses from 39 institutions. Some institutions responded that antihypertensive medication was administered for mild hypertension (140/90 mmHg); these institutions had a lower target blood pressure. Only 56% of institutions measured blood pressure after the onset of labor pains. Postpartum follow-up was carried out not only by obstetric and gynecologic clinics, but also by many institutions. However, sufficient education on the risk of recurrence in subsequent pregnancy and lifestyle guidance were not provided. Conclusions: There is little consensus on the timing of initiating antihypertensive medication, or appropriate levels of blood pressure control. Labor-onset hypertension might have been overlooked. Short-term follow-up of women with HDP was frequently carried out, whereas long-term follow-up was not. We will continue to investigate the appropriate follow-up duration and approach for women with a history of HDP and proactively engage in lifestyle interventions with the aim of improving longevity.