Aim: A questionnaire survey was conducted by the scientific committee of the Japan Society for the Study of Hypertension in Pregnancy (JSSHP) to identify any discrepancies or issues with actual clinical practice regarding the revised definitions and classifications of hypertensive disorders of pregnancy in Japan in 2018.

Methods: We distributed anonymous questionnaires to 623 members of the JSSHP between August and September 2022, and responses were collected using Google Forms.

Results: Valid responses were obtained from 193 physicians. 71.8% of physicians requested the addition of pulmonary edema to maternal organ damage. Most physicians answered that a low platelet count <100,000/μl was appropriate as the diagnostic reference value and that the level of proteinuria was a necessary criterion for severity. Exclusion factors for fetal growth restriction (FGR) due to preeclampsia or superimposed preeclampsia varied among physicians. 74.3% of physicians responded that atypical hypertension needs to be added to the definitions.

Conclusions: The inclusion of pulmonary edema in the list of maternal organ damage, the diagnostic reference value of a low platelet count, and the inclusion of proteinuria in the severe criteria need to be reconsidered. Future challenges include standardizing diagnostic methods for FGR due to preeclampsia and defining atypical preeclampsia.