Clinical practice guideline for the prevention and management of hypertensive disorders of pregnancy
DOI:
https://doi.org/10.18597/rcog.3810Keywords:
Pre-Eclampsia, hypertension, pregnancy-induced, eclampsia, HELLP syndrome, practice guideline, GRADE approach, evidence-based medicineAbstract
Objectives: To provide clinical recommendations based on evidence for the prevention and management of Hypertensive disorders of pregnancy (HDP) in the Social Health Insurance (EsSalud) of Peru.
Methods: A CPG for the the prevention and management of HDP in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and—when it was considered pertinent—primary studies were searched in PubMed y Central during 2021. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice and flowcharts for the prevention, management and follow-up. Finally, the CPG was approved with Resolution 112-IETSI-ESSALUD-2021.
Results: This CPG addressed 8 clinical questions, divided into three topics: prevention, management and follow-up of the HDP. Based on these questions, 11 recommendations (6 strong recommendations and 5 weak recommendations), 32 points of good clinical practice, and 3 flowcharts were formulated.
Conclusions: The main recommendations in the guideline are the use of magnesium sulfate for the treatment of severe pre-eclampsia and eclampsia. The guideline must be updated in three years’ time.
Author Biographies
Omar Yanque-Robles, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima (Perú).
Médico especialista en Ginecología y Obstetricia. Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima (Perú).
Naysha Becerra-Chauca, Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
Licenciada en Obstetricia. Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
Wendy Nieto-Gutiérrez, Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
Médico General. Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
Raúl Alegría Guerrero, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima (Perú).
Médico especialista en Ginecología y Obstetricia. Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima (Perú).
Marco Uriarte-Morales, Hospital II Ramón Castilla, EsSalud, Lima (Perú).
Médico especialista en Ginecología y Obstetricia. Hospital II Ramón Castilla, EsSalud, Lima (Perú).
Wilmer Valencia-Vargas, Policlínico Chincha, EsSalud, Lima (Perú).
Médico especialista en Ginecología y Obstetricia. Policlínico Chincha, EsSalud, Lima (Perú).
Jorge Arroyo-Campuzano, Hospital Nacional Alberto Sabogal Sologuren, EsSalud, Lima (Perú).
Médico especialista en Ginecología y Obstetricia. Hospital Nacional Alberto Sabogal Sologuren, EsSalud, Lima (Perú).
Lourdes Sheillah Torres-Peña, Hospital Luis Negreiros Vega, EsSalud, Lima (Perú).
Médico especialista en Ginecología y Obstetricia. Hospital Luis Negreiros Vega, EsSalud, Lima (Perú).
Rita Ada Meza-Padilla, Gerencia Central de Prestaciones de Salud, EsSalud, Lima (Perú).
Carmen Meza-Luis, Gerencia Central de Prestaciones de Salud, EsSalud, Lima (Perú).
Médico especialista en Medicina Familiar y Comunitaria. Gerencia Central de Prestaciones de Salud, EsSalud, Lima (Perú).
Stefany Salvador-Salvador, Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
Médico especialista en Gestión en Salud. Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
Lourdes Carrera-Acosta, Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
Médico especialista en Gestión en Salud, Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima (Perú).
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