Hypertensive disorders of pregnancy (HDP) is a common but potentially life-threatening complication that affects 5–10% of all pregnancies. Due to the diverse pathologies and multiorgan dysfunction associated with HDP, multidisciplinary treatment is crucial. Moreover, HDP increases the risk of developing chronic diseases later in life and may impact offspring health. In response to these challenges, the Japan Society for the Study of Hypertension in Pregnancy (JSSHP) established the HDP health care provider certification in 2023. The aim is to increase awareness of HDP among medical professionals, expand the number of health care providers with expertise on this condition, and promote women’s health through specialized care during pregnancy, postpartum, and preconception phases. The certification is open to various health care professionals involved in maternity care and requires attending a training session consisting of ten lectures. The first training session, held in September 2023, attracted over 200 participants, with 186 new HDP health care providers certified in January 2024. The majority of certified providers were midwives (49.5%) and medical doctors (36.6%), predominantly obstetricians. The ultimate objective of the HDP health care provider system is to establish a comprehensive support system for women with HDP and their families, utilizing accurate medical knowledge and evidence-based information.

Carperitide, a recombinant form of alpha-human atrial natriuretic peptide, has been widely used in patients with acute heart failure and pulmonary congestion. Here we report five cases of severe pulmonary edema due to preeclampsia treated with carperitide. Five postpartum patients underwent emergency cesarean section because of maternal organ failure at 30⁺² (25⁺²–34⁺²) weeks of gestation and were diagnosed with pulmonary edema prior to or immediately after delivery. Carperitide 0.025 (0.023–0.029) μg/kg/min was administrated postpartum for 3 (2–5) days. After treatment, air space opacification improved, and the cardiothoracic ratio significantly decreased from 54.4% (52.0–61.1) to 49.5% (44.7–51.5) (P=0.038), with a decrease in blood pressure and rapid increase in urine output after initiation of carperitide. Dyspnea improved in all patients, with favorable maternal outcomes and no adverse effects attributable to carperitide. Carperitide may effectively alleviate severe pulmonary edema attributed to preeclampsia, thereby potentially enhancing the overall postpartum health status of affected individuals.

Reversible cerebral vasoconstriction syndrome is characterized by sudden severe headaches, imaging evidence of vasoconstriction, and resolution of symptoms within three months. Reversible cerebral vasoconstriction syndrome is common in women of reproductive age and can be triggered by pregnancy, postpartum conditions, migraine, vasoactive drugs, and vascular injuries. In this case report, we describe a 32-year-old postpartum woman with a history of migraines and smoking who developed reversible cerebral vasoconstriction syndrome after excessive use of a self-administered over-the-counter nasal spray containing naphazoline hydrochloride. Onset of the patient’s headaches occurred after administration of the spray at a dose and frequency significantly exceeding the recommendations in the package insert. Chronic smoking and postpartum vascular changes likely contributed to her condition. Careful monitoring of vasoconstrictive medication use and vascular risk factors during the perinatal period is essential to prevent reversible cerebral vasoconstriction syndrome.