A summary of the 2023 Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) hypertension in pregnancy guideline

Renuka Shanmugalingam; Helen L Barrett; Amanda Beech; Lucy Bowyer; Tim Crozier; Amanda Davidson; Marloes Dekker Nitert; Kerrie Doyle; Luke Grzeskowiak; Nicole Hall; Hicham Ibrahim Cheikh Hassan; Annemarie Hennessy; Amanda Henry; David Langsford; Vincent Ws Lee; Zachary Munn; Michael J Peek; Joanne M Said; Helen Tanner; Rachel Taylor; Meredith Ward; Jason Waugh; Linda Ly Yen; Ellie Medcalf; Katy Jl Bell; Deonna Ackermann; Robin Turner; Angela Makris

doi:10.5694/mja2.52312

A summary of the 2023 Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) hypertension in pregnancy guideline

Med J Aust. 2024 May 19. doi: 10.5694/mja2.52312. Online ahead of print.

Authors

Renuka Shanmugalingam^{1

2}, Helen L Barrett^{3

4}, Amanda Beech^{3

4}, Lucy Bowyer³, Tim Crozier^{5

6}, Amanda Davidson⁷, Marloes Dekker Nitert⁸, Kerrie Doyle², Luke Grzeskowiak⁹, Nicole Hall¹, Hicham Ibrahim Cheikh Hassan^{10

11}, Annemarie Hennessy^{2

12}, Amanda Henry^{4

13}, David Langsford^{14

15}, Vincent Ws Lee^{16

17}, Zachary Munn¹⁸, Michael J Peek^{19

20}, Joanne M Said^{15

21}, Helen Tanner²², Rachel Taylor²³, Meredith Ward³, Jason Waugh²⁴, Linda Ly Yen²⁵, Ellie Medcalf¹⁶, Katy Jl Bell¹⁶, Deonna Ackermann¹⁶, Robin Turner²⁶, Angela Makris^{1

2}

Affiliations

¹ Liverpool Hospital, Sydney, NSW.
² Western Sydney University, Sydney, NSW.
³ Royal Hospital for Women, Sydney, NSW.
⁴ University of New South Wales, Sydney, NSW.
⁵ Monash Medical Centre, Melbourne, VIC.
⁶ Monash University, Melbourne, VIC.
⁷ Australian Pregnancy Hypertension Foundation Limited, Sydney, NSW.
⁸ University of Queensland, Brisbane, QLD.
⁹ Flinders Medical Centre, Flinders University, Adelaide, SA.
¹⁰ Illawarra Shoalhaven Local Health District, Wollongong, NSW.
¹¹ University of Wollongong, Wollongong, NSW.
¹² Campbelltown Hospital, Sydney, NSW.
¹³ St George Hospital, Sydney, NSW.
¹⁴ Grampians Health, Ballarat, VIC.
¹⁵ University of Melbourne, Ballarat, VIC.
¹⁶ University of Sydney, Sydney, NSW.
¹⁷ Westmead Hospital, Sydney, NSW.
¹⁸ Health Evidence Synthesis, Recommendations and Impact (HESRI), University of Adelaide, Adelaide, SA.
¹⁹ Australian National University, Canberra, ACT.
²⁰ Centenary Hospital for Women and Children, Canberra, ACT.
²¹ Joan Kirner Women's and Children's Sunshine Hospital, Melbourne, VIC.
²² Royal Brisbane and Women's Hospital, Brisbane, QLD.
²³ Waikato Women's Hospital, Hamilton, New Zealand.
²⁴ University of Auckland, Auckland, New Zealand.
²⁵ Te Whatu Ora - Health New Zealand Counties Manukau, Auckland, New Zealand.
²⁶ Biostatistics Centre, University of Otago, Dunedin, New Zealand.

PMID: 38763516
DOI: 10.5694/mja2.52312

Abstract

Introduction: Hypertensive disorders of pregnancy (HDP) affect up to 10% of all pregnancies annually and are associated with an increased risk of maternal and fetal morbidity and mortality. This guideline represents an update of the Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) guidelines for the management of hypertensive disorders of pregnancy 2014 and has been approved by the National Health and Medical Research Council (NHMRC) under section 14A of the National Health and Medical Research Council Act 1992. In approving the guideline recommendations, NHMRC considers that the guideline meets NHMRC's standard for clinical practice guidelines.

Main recommendations: A total of 39 recommendations on screening, preventing, diagnosing and managing HDP, especially preeclampsia, are presented in this guideline. Recommendations are presented as either evidence-based recommendations or practice points. Evidence-based recommendations are presented with the strength of recommendation and quality of evidence. Practice points were generated where there was inadequate evidence to develop specific recommendations and are based on the expertise of the working group.

Changes in management resulting from the guideline: This version of the SOMANZ guideline was developed in an academically robust and rigorous manner and includes recommendations on the use of combined first trimester screening to identify women at risk of developing preeclampsia, 14 pharmacological and two non-pharmacological preventive interventions, clinical use of angiogenic biomarkers and the long term care of women who experience HDP. The guideline also includes six multilingual patient infographics which can be accessed through the main website of the guideline. All measures were taken to ensure that this guideline is applicable and relevant to clinicians and multicultural women in regional and metropolitan settings in Australia and New Zealand.

Keywords: Guidelines as topic; Hypertension; Pregnancy, high‐risk; Pre‐eclampsia.

Abstract

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