Dear Colleagues,

The Editorial Team of Hypertension Research in Pregnancy would like to acknowledge all those who have kindly given their precious time to referee submitted papers. We know that reviewing manuscripts is not easy task and they need to have the critical adequate evaluation and the latest scientific knowledge. This prize is awarded biannually to reviewers who reviewed a number of manuscripts submitted to Journal of Hypertension Research in Pregnancy with high quality, speed and impartialness. I would like to thank you for the efforts and contributions.

I am pleased to announce the Best Reviewer Awards for 2018–2019.

Best Reviewer Award of 2018–2019

* Shintaro Makino, MD, PhD.

Department of Obstetrics and Gynecology, Urayasu Hospital, Juntendo University, Chiba

Number of Reviews: 6

* Jun Takeda, MD, PhD.

Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, Tokyo

Number of Reviews: 5

Many facilities in Japan currently perform elective cesarean section for term singleton breech presentation, and young doctors training in obstetrics and gynecology may not have had a chance to experience vaginal breech delivery. However, vaginal breech delivery remains an option if comprehensive informed consent is obtained. To reduce the incidence of nuchal arm, “transverse figure 8 breech delivery (TF8 maneuver)” has been widely recommended in Japan. This review discusses trends in mode of breech delivery in Japan, with a focus on the TF8 maneuver.

Aim: A questionnaire survey was conducted by the scientific committee of the Japan Society for the Study of Hypertension in Pregnancy (JSSHP) to clarify whether the measurement of blood pressure in pregnant women and management of hypertensive disorders of pregnancy differ between obstetricians.

Methods: We distributed anonymous questionnaires to 624 members of the JSSHP by mail in May 2019.

Results: Valid responses were obtained from 206 obstetricians. The majority of obstetricians used an automatic sphygmomanometer to screen for hypertension in clinical settings. Home blood pressure measurements were used by 97% of obstetricians to diagnose white coat hypertension. However, blood pressure measurements performed by many obstetricians in clinical and non-clinical settings did not comply with standards for non-pregnant adults. Furthermore, blood pressure goals in women with hypertensive disorders of pregnancy varied among obstetricians.

Conclusions: In Japan, an automatic sphygmomanometer in clinical settings and home blood pressure measurements in non-clinical settings are commonly used in practice for pregnant women. However, obstetricians may need to be re-educated on how to perform correct blood pressure measurements in these settings. Further evidence is needed to establish appropriate blood pressure goals in pregnant women with hypertensive disorders of pregnancy.

Few reports have described the impact of chemical pregnancy on a viable fetus in heterotopic cervical pregnancy. A 38-year-old primigravida was transferred to our hospital with severe abdominal pain at 32 weeks of gestation. She was tentatively diagnosed with placental abruption with intrauterine fetal death (IUFD), and a stillborn fetus was delivered vaginally. Massive vaginal bleeding continued during labor and was uncontrolled after delivery, requiring a hysterectomy. Macroscopic examination revealed a solid nodule in the uterine cervix. Histologically, the nodule consisted of villous tissue. Fluorescent in situ hybridization revealed two placental tissues derived from different embryos, indicating heterotopic cervical pregnancy. Although pregnancy was achieved after double embryo transfer, no early ultrasound findings suggested cervical pregnancy. This is the first report of heterotopic cervical pregnancy in which retained products after a chemical pregnancy caused sudden massive hemorrhage and IUFD in the third trimester.

We describe the emergency measures taken in response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in an obstetrics ward in Japan. In April 2020, two midwives in our obstetric ward were diagnosed with SARS-CoV-2 infection. We immediately closed the ward and performed polymerase chain reaction (PCR) testing for 25 patients and 42 staff members who had possible contact with the midwives. Pregnant women at or near term were referred to nearby obstetric facilities. One patient, who delivered before the midwives were diagnosed, and her neonate tested positive for SARS-CoV-2. All other tested patients and staff had negative PCR test results. In total, 14 pregnant women at term and 15 at 34–36 weeks gestation were referred to other facilities. Of these, 13 delivered in transfer destinations and 16 delivered in our hospital after a 14-day temporary closure of the ward. Our prompt measures successfully prevented the nosocomial spread of coronavirus disease.