From Local Evidence to Regional Leadership: Post-Preeclampsia Care in Thailand
TL;DR
A standardized multicenter pilot is proposed comprising documented risk communication and a named receiving provider before discharge; blood-pressure evaluation within 72 hours for women with severe hypertension and no later than 7–10 days for other women with hypertensive disorders; structured assessment at 6–12 weeks and 6–12 months; permanent recording of hypertensive pregnancy history; and annual cardiovascular-risk review.
Abstract
Abstract Hypertensive disorders of pregnancy, particularly preeclampsia, identify women at increased risk of persistent hypertension and later cardiovascular disease, yet postpartum services often remain organized around short-term obstetric recovery. Thailand is well positioned to address this discontinuity because prospective local studies have demonstrated elevated blood pressure, hypertension, and selected cardiovascular and renal risk markers at 6 weeks and 6–12 months after preeclampsia or gestational hypertension. The principal policy gap is therefore not the absence of warning evidence, but the lack of a standardized and auditable handover from maternity services to primary care and cardiovascular prevention. This commentary was informed by a targeted, non-systematic examination of peer-reviewed studies, international professional recommendations, World Health Organization resources, and publicly accessible national guidance available in English through June 2026. Evidence was selected to characterize longer-term cardiovascular and renal risk following hypertensive disorders of pregnancy, summarize relevant Thai postpartum findings, and identify regional health-system approaches that could inform continuity of care in Thailand. Vietnam, Malaysia, and Mongolia were purposively selected as complementary examples of community noncommunicable-disease integration, local-clinic follow-up after hypertensive pregnancy, and continuity of care across geographic distance, respectively. We propose a standardized multicenter pilot comprising documented risk communication and a named receiving provider before discharge; blood-pressure evaluation within 72 hours for women with severe hypertension and no later than 7–10 days for other women with hypertensive disorders; structured assessment at 6–12 weeks and 6–12 months; permanent recording of hypertensive pregnancy history; and annual cardiovascular-risk review. National scale-up should follow evaluation of feasibility, completion, equity, and clinical outcomes. The aim is not to create a parallel specialty service, but to convert an established obstetric warning sign into accountable long-term cardiovascular and renal prevention.