Am Fam Physician. 2025;111(1):online
Related Putting Prevention into Practice: Screening for Hypertensive Disorders of Pregnancy
As published by the USPSTF.
| What does the USPSTF recommend? | Pregnant persons: Screen for hypertensive disorders of pregnancy with blood pressure measurements throughout pregnancy. Grade: B |
| To whom does the recommendation apply? | This recommendation applies to all pregnant women and pregnant persons of all genders without a known diagnosis of a hypertensive disorder of pregnancy or chronic hypertension. |
| What's new? | This recommendation is consistent with the 2017 USPSTF recommendation statement on screening for preeclampsia. The USPSTF broadened the scope of the updated review to screening for hypertensive disorders of pregnancy. |
| How to implement this recommendation? | Blood pressure measurements should be obtained during each prenatal care visit throughout pregnancy. If a patient has an elevated blood pressure reading, the reading should be confirmed with repeated measurements. To achieve the benefit of screening, it is important that persons who screen positive receive evidence-based management of hypertensive disorders of pregnancy. |
| What additional information should clinicians know about this recommendation? | While it is known that risk continues into the immediate postpartum period, there is little evidence regarding screening during this period. A pragmatic approach would be for patients to be counseled regarding signs and symptoms of preeclampsia at hospital discharge and for patients with hypertensive disorders to have subsequent blood pressure checks. |
| Why are this recommendation and topic important? | Hypertensive disorders of pregnancy are among the leading causes of maternal morbidity and mortality as well as adverse perinatal outcomes for the fetus and newborn. Black persons experience higher rates of maternal and infant morbidity and perinatal mortality than other racial and ethnic groups and are at greater risk for developing hypertensive disorders of pregnancy than other pregnant persons. |
| What are other relevant USPSTF recommendations? | The USPSTF recommends the use of low-dose aspirin (81 mg per day) as preventive medication after 12 weeks of gestation in persons at high risk for preeclampsia. |
| What are additional tools and resources? | Million Hearts is a national initiative that provides tools and resources for cardiovascular health, including hypertensive disorders of pregnancy (https://millionhearts.hhs.gov/tools-protocols/tools/hypertension-disorders-pregnancy.html). The National Institute of Child Health and Human Development has information on preeclampsia and eclampsia (https://www.nichd.nih.gov/health/topics/preeclampsia). The Centers for Disease Control and Prevention has information about high blood pressure during pregnancy (https://www.cdc.gov/high-blood-pressure/about/high-blood-pressure-during-pregnancy.html). The Community Preventive Services Task Force recommends exercise programs for pregnant women to reduce the development of gestational hypertension (https://www.thecommunityguide.org/findings/pregnancy-health-exercise-programs-prevent-gestational-hypertension.html). |
| Where to read the full recommendation statement? | Visit the USPSTF website (https://www.uspreventiveservicestaskforce.org/) or the JAMA website (https://jamanetwork.com/collections/44068/united-states-preventive-services-task-force) to read the full recommendation statement. This includes more details on the rationale of the recommendation, including benefits and harms; supporting evidence; and recommendations of others. |
The full recommendation statement is available at https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertensive-disorders-pregnancy-screening. The USPSTF recommendations are independent of the US government. They do not represent the views of the Agency for Healthcare Research and Quality, the US Department of Health and Human Services, or the US Public Health Service.
