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In Pregnancy
SOCIETY STATEMENT
Outline of Definition and
Classification of Pregnancy induced
Hypertension (PIH)
K. Watanabe et al.
Key words:
definition, pregnancy induced
hypertension, preeclampsia
In this report, we present the terminology, definition and classification of pregnancy induced hypertension (PIH) by the
Japan Society for the Study of Hypertension in Pregnancy (JSSHP). PIH is classified as gestational hypertension (GH),
preeclampsia (PE), superimposed preeclampsia (S-PE) or eclampsia (E). Subclassifications by symptoms (severity and
gestational age at onset) are also shown.
Terminology
Definition
PIH is defined as hypertension (blood pressure 140/90
mmHg) with or without proteinuria ( 300 mg/24 hours)
emerging after 20 weeks gestation, but resolving up to 12
weeks postpartum.110) PIH is also defined as new onset
proteinuria ( 300 mg/24 hours) in hypertensive women
who exhibit no proteinuria before 20 weeks gestation.
Classification
Gestational hypertension (GH)
Preeclampsia (PE)
Eclampsia (E)
Subclassification by symptoms
*Severity*
The severity of PIH is assessed by the extent of
symptoms. Both blood pressure and proteinuria are
dependable indicators of severity.
Appendix
Pulmonary edema, stroke, and HELLP syndrome are
considered severe variants, and are excluded from the
definition or classification of PIH.
Gestational proteinuria and edema are excluded from
PIH symptoms.
References
1. Japan Society for the Study of TOXEMIA OF PREGNANCY. ed.
Historical Perspective of Study of Pregnancy-Induced Hypertension
in Japan. Tokyo: Medical View Co., Ltd., 2005. (In Japanese.)
2. Japan Society for the Study of Hypertension in Pregnancy. ed.
Guideline 2009 for care and treatment of hypertension in pregnancy
(PIH). Tokyo: Medical View Co., Ltd., 2009. (In Japanese.)
3. National High Blood Pressure Education Program Working Group
Report on High Blood Pressure in Pregnancy. Am J Obstet
Gynecol. 1990; 163: 1691 1712.
4. North RA, Tayler RS, Schllenberg JC. Evaluation of a definition of
preeclampsia. Br J Obstet Gynaecol. 1999; 106: 767 773.