Figure 1
Flowchart presenting the selection of guidelines on CVD in pregnancy modified from PRISMA ScR.
WHO- World Health Organization, ESC- European Society of Cardiology, FIGO- The International Federation of Gynaecology and Obstetrics, ISSHP- International Society for the Study of Hypertension in Pregnancy, MOH- Ministry of Health, BCS- Brazilian Cardiology Society, CMA- Chinese Medical Association, SLCOG- Sri Lanka College of Obstetricians and Gynaecologists, SOGP- Society of Obstetricians and Gynaecologists Pakistan.
| Category | Inclusion Criteria | Exclusion Criteria |
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| Population (organizations) |
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| Concept |
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| Context |
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| Types of sources |
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Table 1
Scope of guidelines on HDP and CVD in pregnancy.
| PUBLISHER | TYPE OF PUBLISHER | CLINICAL CONDITION FOCUSED | STAGE OF PREGNANCY FOCUSED | AIM OF THE GUIDELINE RECOMMENDATIONS (PREVENTION/SCREENING/MANAGEMENT) |
|---|---|---|---|---|
| WHO (19, 20, 21, 22, 23, 24, 25) | WHO | Preeclampsia, Hypertension | Preconception; Antenatal | Prevention; Management |
| ESC (4) | IPO | CVD | Preconception; Antenatal; Intrapartum; and Postpartum | Prevention; Screening; Management |
| FIGO (26) | IPO | Preeclampsia | Antenatal | Prevention; Screening |
| ISSHP (27) | IPO | HDP | Antenatal; Intrapartum; Postpartum and long-term follow-up | Prevention; Screening; Management |
| MOH, Malaysia (28) | MOH | CVD | Preconception; Antenatal; Intrapartum; Postpartum and long-term follow-up | Prevention; Screening; Management |
| MOH, Peru (30) | MOH | HDP | Antenatal; Intrapartum | Prevention; Management |
| MOH, South Africa (29) | MOH | HDP | Antenatal; Intrapartum; Postpartum and long-term follow-up | Prevention; Screening; Management |
| BCS, Brazil (32) | NPO | CVD | Preconception; Antenatal; Intrapartum and Postpartum | Prevention; Screening; Management |
| CMA, China (31) | NPO | HDP | Preconception; Antenatal; Intrapartum; Postpartum and long-term follow-up | Prevention; Screening; Management |
| SLCOG, Sri Lanka (34) | NPO | HDP | Preconception; Antenatal; Intrapartum and Postpartum | Prevention; Screening; Management |
| SOGP, Pakistan (33) | NPO | HDP | Preconception; Antenatal; Intrapartum; Postpartum and long-term follow-up | Prevention; Screening; Management |
[i] CVD, cardiovascular diseases; HDP, hypertensive diseases of pregnancy.
WHO, World Health Organization; ESC, European Society of Cardiology; FIGO, The International Federation of Gynaecology and Obstetrics; ISSHP, International Society for the Study of Hypertension in Pregnancy; MOH, Ministry of Health; BCS, Brazilian Cardiology Society; CMA, Chinese Medical Association; SLCOG, Sri Lanka College of Obstetricians and Gynaecologists; SOGP, Society of Obstetricians and Gynaecologists Pakistan.
Table 2
Recommendations for dosage of aspirin and calcium by the guidelines to prevent preeclampsia during pregnancy.
| PUBLISHER | ASPIRIN DOSE (mg) | CALCIUM DOSE (g) |
|---|---|---|
| WHO | 75 | 1.2–2 |
| ESC | 100–150 | 1.5–2 |
| FIGO | 150 | 1.5–2 |
| ISSHP | 150 | 1.2–2.5 |
| MOH, Malaysia | 75 | Calcium not recommended |
| MOH, Peru | 100–150 | 2 |
| MOH, South Africa | 75–162 | 0.5 |
| BCS, Brazil | 75–150 | 1.5–2 |
| CMA, China | 50–150 | 1 |
| SLCOG, Sri Lanka | 150 | 1 |
| SOGP, Pakistan | 75–150 | Calcium not recommended |
[i] WHO, World Health Organization; ESC, European Society of Cardiology; FIGO, The International Federation of Gynaecology and Obstetrics; ISSHP, International Society for the Study of Hypertension in Pregnancy; MOH, Ministry of Health; BCS, Brazilian Cardiology Society; CMA, Chinese Medical Association; SLCOG, Sri Lanka College of Obstetricians and Gynaecologists; SOGP, Society of Obstetricians and Gynaecologists Pakistan.
Table 3
Recommended timing and duration of Aspirin administration during pregnancy by the guidelines.
| PUBLISHER | COMMENCEMENT TIME OF ASPIRIN ADMINISTRATION (IN WEEKS OF GESTATION) | TIME OF CESSATION OF ASPIRIN ADMINISTRATION (IN WEEKS OF GESTATION) |
|---|---|---|
| WHO | 20 weeks, or as soon as antenatal care started | Not mentioned in the guideline |
| ESC | 12 | 36–37 |
| FIGO | 11–14 | 36 or until preeclampsia is diagnosed |
| ISSHP | Before 16, definitely before 20 weeks | Delivery |
| MOH, Malaysia | 12 | Delivery |
| MOH, Peru | 12–16 | Not mentioned in the guideline |
| MOH, South Africa | 12–14 (up to 20) | Not mentioned in the guideline |
| BCS, Brazil | 12–16 | 5 days before delivery |
| CMA, China | 12–16 | 26–28 |
| SLCOG, Sri Lanka | Before 16 | 36 weeks |
| SOGP, Pakistan | 13 | Delivery |
[i] WHO, World Health Organization; ESC, European Society of Cardiology; FIGO, The International Federation of Gynaecology and Obstetrics; ISSHP, International Society for the Study of Hypertension in Pregnancy; MOH, Ministry of Health; BCS, Brazilian Cardiology Society; CMA, Chinese Medical Association; SLCOG, Sri Lanka College of Obstetricians and Gynaecologists; SOGP, Society of Obstetricians and Gynaecologists Pakistan.
Table 4
Non-pharmacological interventions recommended for the management of HDP.
| TYPE OF PUBLISHER | PUBLISHER | NON-PHARMACOLOGICAL INTERVENTIONS | |||||
|---|---|---|---|---|---|---|---|
| SALT RESTRICTION | VITAMIN SUPPLEMENTATION | PHYSICAL ACTIVITY | ALCOHOL RESTRICTION | TOBACCO RESTRICTION | RISK COUNSELING | ||
| WHO | – | – | – | – | – | – | |
| International Professional Organization | ESC | – | × | ✓ | ✓ | ✓ | ✓ |
| FIGO | – | – | – | – | – | – | |
| ISSHP | – | × | ✓ | – | – | – | |
| Ministry of Health | MOH, Malaysia | – | ✓ | ✓ | ✓ | ✓ | ✓ |
| MOH, Peru | – | – | – | – | – | – | |
| MOH, South Africa | – | – | – | – | – | – | |
| National Professional Organization | BCS, Brazil | × | × | ✓ | ✓ | ✓ | ✓ |
| CMA, China | ✓ | ✓ | ✓ | ✓ | |||
| SLCOG, Sri Lanka | × | – | ✓ | – | – | ✓ | |
| SOGP, Pakistan | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
[i] Legend: ✓, recommended; ×, not recommended; –, no recommendation available in the guideline.
WHO, World Health Organization; ESC, European Society of Cardiology; FIGO, The International Federation of Gynaecology and Obstetrics; ISSHP, International Society for the Study of Hypertension in Pregnancy; MOH, Ministry of Health; BCS, Brazilian Cardiology Society; CMA, Chinese Medical Association; SLCOG, Sri Lanka College of Obstetricians and Gynaecologists; SOGP, Society of Obstetricians and Gynaecologists Pakistan.