Abstract
Aim: The definition and classification of hypertensive disorders of pregnancy were revised in 2018. This study aimed to evaluate the degree to which the new definition (especially that of uteroplacental dysfunction) was accepted and understood by Japanese obstetricians for the two years immediately following the revision (2018–2020).
Methods: The scientific committee of the Japan Society for the Study of Hypertension in Pregnancy (JSSHP) surveyed the current state of the diagnosis and management of uteroplacental dysfunction in hypertensive disorders of pregnancy. An online, anonymous questionnaire was distributed to 625 JSSHP members via Research Electronic Data Capture (REDCap) software in February 2020.
Results: Valid responses were obtained from 147 obstetricians. In normal pregnancies, 75% of obstetricians measured fetal growth at each visit, and the frequency of uteroplacental dysfunction increased in the order of chronic hypertension, gestational hypertension, and preeclampsia. Approximately 70% of obstetricians accepted uteroplacental dysfunction as a preeclampsia diagnostic criterion. The majority included fetal growth restriction when diagnosing uteroplacental dysfunction, but there was wide variation among obstetricians who included findings other than FGR (such as abnormal umbilical artery Doppler flow and stillbirth). Although uteroplacental dysfunction was frequently the reason for admission, criteria for determining pregnancy termination varied widely.
Conclusions: In Japan, frequent ultrasonography is performed to diagnose uteroplacental dysfunction. Many obstetricians include uteroplacental dysfunction as a diagnostic criterion for preeclampsia, and these patients are carefully managed. However, there is wide variation in diagnostic criteria and management policies.
