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JAMA Patient Page
April 25, 2017

Screening for Preeclampsia During Pregnancy

JAMA. 2017;317(16):1700. doi:10.1001/jama.2017.3988

The US Preventive Services Task Force (USPSTF) has recently published recommendations on screening for preeclampsia in pregnant women.

What Is Preeclampsia?

Preeclampsia is a serious condition that causes high blood pressure during pregnancy. It can begin during the second half of pregnancy, during labor, or shortly after delivery. In addition to high blood pressure, preeclampsia can cause problems with the kidneys, the liver, and sometimes the eyes and brain. Some women with preeclampsia have a higher-than-normal level of protein in their urine. Preeclampsia also leads to poor growth of the fetus in the womb.

Symptoms of preeclampsia can include headaches, changes in vision, abdominal pain, or swelling of the legs, but these symptoms can all occur in a healthy pregnancy as well. Many women with preeclampsia have no symptoms.

The treatment for preeclampsia is to deliver the baby. If it is too early in the pregnancy for delivery, some women are monitored and given medications to lower blood pressure and/or magnesium supplementation until their doctor decides the time is right to deliver.

What Tests Are Used to Screen for Preeclampsia?

Screening for preeclampsia is done by measuring blood pressure at each prenatal visit. This is done using a sphygmomanometer, which measures blood pressure with a manually inflatable cuff that goes around the upper arm. Urine tests to look for protein can be used to confirm the diagnosis of preeclampsia, but in-office urine “dipstick” tests are not recommended as screening tests.

What Is the Patient Population Under Consideration for Screening for Preeclampsia?

This USPSTF recommendation applies to all pregnant women who do not have a history of preeclampsia or high blood pressure.

What Are the Potential Benefits and Harms of Screening for Preeclampsia?

Preeclampsia can escalate quickly from a mild to a life-threatening condition; therefore, finding and treating preeclampsia earlier rather than later is important. There is good evidence that treating preeclampsia leads to major health benefits for both mothers and babies. Blood pressure measurements are generally accurate tests, and potential harms from false-positive or negative readings are small.

How Strong Is the Recommendation to Screen for Preeclampsia?

The USPSTF concludes with moderate certainty that the benefits of screening for preeclampsia in pregnant women substantially outweigh the harms.

Bottom Line: Current Recommendation for Screening for Preeclampsia

The USPSTF recommends screening for preeclampsia with blood pressure measurements throughout pregnancy (a “B” recommendation).

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Article Information

Source: US Preventive Services Task Force. Preeclampsia screening: US Preventive Services Task Force recommendation statement. JAMA. doi:10.1001/jama.2017.3439

Topic: Preventive Medicine