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

Abstract

Aim To clarify the appropriate management of hypertensive disorder of pregnancy (HDP) and establish a long-term follow-up system for women with HDP after delivery. We investigated issues with HDP management approaches by evaluating blood pressure measurement on medical examination, home blood pressure measurement (HBPM) penetration rate, time of blood pressure examination during labor, and follow-up procedure after delivery in women with HDP. Methods We distributed questionnaires on blood pressure management during pregnancy, at delivery, and after delivery to 53 obstetrics and gynecology departments of professional medical institutions in Aomori prefecture, Japan. Results We retrieved completed questionnaires from 52 institutions, and analyzed responses to questionnaires from pregnant women in 39 institutions. Some institutions reported that antihypertensive medication was begun for mild hypertension (140/90 mmHg); these institutions had set a lower target BP. Only 56% of institutions measured blood pressure after labor pain onset. The postpartum follow-up was carried out not only by obstetric and gynecological clinics, but also by many institutions. However, sufficient education on the risk of recurrence in a subsequent pregnancy and lifestyle guidance were not provided. Conclusions There is little consensus on the timing of antihypertensive medication initiation or the appropriate level of blood pressure control. Labor onset hypertension may have been overlooked. Short-term follow-up of women with HDP was found to be frequently carried out; however, long-term follow-up was not. We will continue to provide the appropriate follow-up duration and approach to women with a history of HDP and to proactively engage in lifestyle interventions with the aim of improving longevity.