Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan
Background: Unlike Europe and the United States, Japan has seen numerous maternal deaths from hemorrhagic strokes related to hypertensive disorders of pregnancy (HDP). This study retrospectively analyzed deaths associated with HDP-related hemorrhagic stroke in Japan to determine the number of deaths...
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| Format: | Article |
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MDPI AG
2023-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/8/2908 |
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| author | Hiroaki Tanaka Junichi Hasegawa Shinji Katsuragi Kayo Tanaka Tatsuya Arakaki Masamitsu Nakamura Eijiro Hayata Masahiko Nakata Akihiko Sekizawa Isamu Ishiwata Tomoaki Ikeda |
| author_facet | Hiroaki Tanaka Junichi Hasegawa Shinji Katsuragi Kayo Tanaka Tatsuya Arakaki Masamitsu Nakamura Eijiro Hayata Masahiko Nakata Akihiko Sekizawa Isamu Ishiwata Tomoaki Ikeda |
| author_sort | Hiroaki Tanaka |
| collection | DOAJ |
| description | Background: Unlike Europe and the United States, Japan has seen numerous maternal deaths from hemorrhagic strokes related to hypertensive disorders of pregnancy (HDP). This study retrospectively analyzed deaths associated with HDP-related hemorrhagic stroke in Japan to determine the number of deaths that may have been prevented with blood pressure control during pregnancy. Methods: This study included maternal deaths related to hemorrhagic stroke cases. The proportion of patients without proteinuria whose blood pressure exceeded 140/90 mmHg between 14+0 and 33+6 weeks of gestation were determined. Lastly, the application of tight antihypertensive management was evaluated. Results: Among 34 HDP-related maternal deaths, 4 cases involved patients without proteinuria whose blood pressures exceeded 140/90 mmHg between 14+0 and 33+6 weeks of gestation. These included two chronic hypertension and two gestational hypertension cases. None of the patients received antihypertensive agents, and their blood pressures were managed leniently. Conclusion: Among HDP-related hemorrhagic stroke deaths in Japan, only a few cases of maternal death could have been prevented with tight blood pressure management, as described in the CHIPS randomized controlled trial. Therefore, to prevent HDP-related hemorrhagic stroke in Japan, new preventive strategies during pregnancy should be established. |
| first_indexed | 2024-03-11T04:54:25Z |
| format | Article |
| id | doaj.art-ccbfd17146254e539f71146dd46676a7 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:54:25Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-ccbfd17146254e539f71146dd46676a72023-11-17T19:50:09ZengMDPI AGJournal of Clinical Medicine2077-03832023-04-01128290810.3390/jcm12082908Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in JapanHiroaki Tanaka0Junichi Hasegawa1Shinji Katsuragi2Kayo Tanaka3Tatsuya Arakaki4Masamitsu Nakamura5Eijiro Hayata6Masahiko Nakata7Akihiko Sekizawa8Isamu Ishiwata9Tomoaki Ikeda10Department of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi 2-174, Tsu 514-8507, Mie, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanJapan Maternal Death Exploratory Committee, Ichigayahachimantyou 14, Shinjuku, Tokyo 162-0844, JapanDepartment of Obstetrics and Gynecology, Mie University School of Medicine, Edobashi 2-174, Tsu 514-8507, Mie, JapanBackground: Unlike Europe and the United States, Japan has seen numerous maternal deaths from hemorrhagic strokes related to hypertensive disorders of pregnancy (HDP). This study retrospectively analyzed deaths associated with HDP-related hemorrhagic stroke in Japan to determine the number of deaths that may have been prevented with blood pressure control during pregnancy. Methods: This study included maternal deaths related to hemorrhagic stroke cases. The proportion of patients without proteinuria whose blood pressure exceeded 140/90 mmHg between 14+0 and 33+6 weeks of gestation were determined. Lastly, the application of tight antihypertensive management was evaluated. Results: Among 34 HDP-related maternal deaths, 4 cases involved patients without proteinuria whose blood pressures exceeded 140/90 mmHg between 14+0 and 33+6 weeks of gestation. These included two chronic hypertension and two gestational hypertension cases. None of the patients received antihypertensive agents, and their blood pressures were managed leniently. Conclusion: Among HDP-related hemorrhagic stroke deaths in Japan, only a few cases of maternal death could have been prevented with tight blood pressure management, as described in the CHIPS randomized controlled trial. Therefore, to prevent HDP-related hemorrhagic stroke in Japan, new preventive strategies during pregnancy should be established.https://www.mdpi.com/2077-0383/12/8/2908maternal deathhemorrhagic strokeCHIPS randomized controlled trial |
| spellingShingle | Hiroaki Tanaka Junichi Hasegawa Shinji Katsuragi Kayo Tanaka Tatsuya Arakaki Masamitsu Nakamura Eijiro Hayata Masahiko Nakata Akihiko Sekizawa Isamu Ishiwata Tomoaki Ikeda Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan Journal of Clinical Medicine maternal death hemorrhagic stroke CHIPS randomized controlled trial |
| title | Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan |
| title_full | Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan |
| title_fullStr | Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan |
| title_full_unstemmed | Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan |
| title_short | Are There Maternal Deaths Related to Hemorrhagic Stroke Due to Hypertensive Disorder of Pregnancy That Could Be Potentially Preventable by Tight Hypertension Management in Antepartum? A Retrospective Study from the Maternal Death Exploratory Committee in Japan |
| title_sort | are there maternal deaths related to hemorrhagic stroke due to hypertensive disorder of pregnancy that could be potentially preventable by tight hypertension management in antepartum a retrospective study from the maternal death exploratory committee in japan |
| topic | maternal death hemorrhagic stroke CHIPS randomized controlled trial |
| url | https://www.mdpi.com/2077-0383/12/8/2908 |
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