Page 187 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

Table 4.1. International guidelines on postpartum follow-up and lifestyle intervention
after preeclampsia
Guideline
NICE288 (England)
ACOG287 (USA)
SGOC289 (Canada)
SOMANZ290 (Australia, New- Sealand)
DSOG291 (Netherlands)
Year Follow-up hypertension
2011 None
2013 None
2014 Until well controlled, if
difficult to control: referral to internal medicine
2014 None
2014 Until normotensive
Follow-up proteinuria
None
None
If persistent at 3-6 months postpartum: referral to nephrology
None
None
Cardiometabolic screening
None
Yearly extensive screening if delivery <37 weeks
Once at least 6 weeks postpartum extensive screening
Yearly blood pressure 5-yearly extensive screening Extensive screening at the age of 50 years
Advice on lifestyle
Inform women about increased risk, intervention not mentioned
Recommend lifestyle modification
Women should pursue a healthy lifestyle
Counsel women that they will benefit from a healthy lifestyle
Counsel women to maintain a healthy lifestyle
Discussion| 185
NICE = The National Institute for Health and Care Excellence
ACOG = American Congress of Obstetricians and Gynecologists
SGOC = The Society of Obstetricians and Gynecologists of Canada SOMANZ = Society of Obstetric Medicine of Australia and New Zealand DSOG = Dutch Society of Obstetrics and Gynecology
still leave a significant gap with observed odds-ratios.
The model we used to estimate the independent risk of preeclampsia for
future cardiovascular disease had limitations that could have overestimated the