AGREE II; Clinical guidelines; Clinical variation; Guideline review; Induction of labour.

HHS (moderate-quality evidence, weak recommendation), Hypertensive disorders of pregnancy are an important cause of severe morbidity, long-term disability and death among both mothers and their babies. 2009 Apr;116(5):626-36. doi: 10.1111/j.1471-0528.2008.02065.x. 0000019735 00000 n Severe preeclampsia should be defined as preeclampsia complicated by one or more severe complications. doi: 10.1002/14651858.CD012910. Dissemination and implementation of the guidelines 29 7. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. (1) When a policy of induction of labour (aim within 24 hours) was compared with expectant management, there was no case of eclampsia, maternal death or perinatal death recorded in both arms of the trial.

doi: 10.1503/cmaj.73257. 0000002607 00000 n Get the latest public health information from CDC: https://www.coronavirus.gov. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. 0000016428 00000 n Geneva: World Health Organization, 2011. Labetalol or nifedipine is recommended for long-term treatment of pregnant women. Brown et al Hypertension in Pregnancy: ISSHP Recommendations 25 7. 0000003300 00000 n 0000000938 00000 n Indications where guidelines had mostly consistent advice included prolonged pregnancy (induction between 41 and 42 weeks), preterm premature rupture of membranes, and term preeclampsia (induction when preeclampsia diagnosed ≥37 weeks). WHO recommendation on induction for women with mild pre-eclampsia or mild gestational hypertension at term (October 2011). 0000000016 00000 n This evidence is indirectly applied to women with severe pre-eclampsia, at term for supporting a policy of early delivery. Jimmy Espinoza, M.D., and colleagues from ACOG discuss the diagnosis and management of gestational hypertension and preeclampsia. in women with mild pre-eclampsia or mild gestational hypertension at term (P), does induction of labour (I) compared to expectant management (C), improve maternal and perinatal outcomes (O)? A Call-to-Action to Accelerate Development and Adoption of Biomarkers. Remarks were added to clarify the recommendation, and aid implementation. WHO Reproductive Health Library. The guideline development group considered that, in women with pre-eclampsia at term, expectant management is associated with a substantial risk of further maternal and fetal complications and absence of substantial maternal and fetal benefits. This guideline provides global, evidence-informed recommendations on daily iron supplementation in infants and children, as a public-health intervention for the prevention of anaemia and iron deficiency. trailer Our goal is to provide resources for patients and their caregivers to ensure all women receive timely diagnosis and appropriate treatment. This review identified one multicentre RCT conducted in the Netherlands that had recruited a total of 756 women with mild pre-eclampsia or gestational hypertension after 36 weeks’ gestation. BJOG. For women with gestational hypertension or preeclampsia at 37 weeks of gestation or later without severe features, the guidelines recommend delivery rather than expectant management. 0000018119 00000 n Select one or more newsletters to continue. Quality of evidence provided by the Hypitat trial (1) was further downgraded for indirectness. ACOG Updates Guidelines for Gestational HTN, Preeclampsia, We comply with the HONcode standard for trustworthy health information -, Gestational Hypertension and Preeclampsia. This video provides an overview of performance of catheterization of the bladder. 0000002392 00000 n No. A seven-day antibiotic regimen is recommended for all pregnant women with asymptomatic bacteriuria (ASB) to prevent persistent bacteriuria, preterm birth and low birth weight. WHO convened a Guideline Development Group (GDG) meeting on recommendations for prevention and treatment of pre-eclampsia or eclampsia in April 2011, where this recommendation was developed. This site needs JavaScript to work properly. Some practice variation may stem from variability in clinical guidelines. Geneva: World Health Organization, 2011. WHO Reproductive Health Library. 0 The authors recommend that women with any high-risk factors for preeclampsia or those with more than one moderate risk factor receive low-dose aspirin for prophylaxis, initiated between 12 and 28 weeks of gestation and continuing until delivery. Evidence profiles (in the form of GRADE tables) were prepared for comparisons of interest, including the assessment and judgments for each outcome, and the estimated risks.

0000009467 00000 n We are very proud and incredi... Visit our COVID-19 and Preeclampsia resource page. The term PIH (pregnancy-induced hypertension) should be abandoned, as its meaning in clinical practice is unclear. More research is needed on the benefits and potential harms of a policy of labour induction for mild pre-eclampsia or gestational hypertension at term in settings where accurate gestational age assessment is difficult due to late initiation of antenatal care.

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