The main results of our first online survey is to underline that women who experienced a preeclampsia episode cruelly lacked information about their cardiovascular risks and about the possibility that preeclampsia was a sign or a harbinger of a kidney disease, and this lack of information is of course linked to lack of awareness that preventive measures should be taken.

This is a dismal consideration considering also that in our survey many women actually had a postnatal consultation, which could have been be an opportunity to deliver the information and to plan care trajectories.

This consideration is not unique. While very few studies report on this issue, a recent, large French study, the CONCEPTION study, including 2,663,573 women after pregnancy, 6.73% of whom experienced a hypertensive disorder of pregnancy, reported that overall only 1% consulted with a cardiologist in the first year after delivery (and only about 5% after preeclampsia or gestational hypertension), and reported that the median delay in consulting a cardiologist after a hypertensive disorder of pregnancy was between 6 months and one year in women who had had a complicated pregnancy [2]. The lack of opportunities for the mothers is important: a recent study from the UK reports that 65% of the cardiovascular complications that occurred in women who presented a hypertensive disorder of pregnancy were recorded before 40 years of age [3]. Similarly, the authors of the “ABC” found that in Le Mans, France and in Cagliari, Italy about 20% of women who were evaluated after an episode of preeclampsia had an underlying kidney disease [4].

It is therefore essential to act as early as possible in the postpartum period, while respecting the psychological condition of the patient. Some are very traumatized and shocked, and might prefer to “forget about it” (their words), but they mainly refer to their psychological suffering which has to be treated by a specialist. Once informed about the risk to their long-term cardiovascular health, no woman wants to be neglected or ignored. And above all, women no longer want to be infantilized (and are fed up with doctors making decisions on their behalf without informing them).

Early follow-up is essential for the identification of risk factors and early care of diseases, and transmitting information to patients about their condition may empower them to be active (1) with regard to their health. The involvement of associations as witnesses (2) during the conception of guidelines may increase the transfer and diffusion of information.

Follow-up of subsequent pregnancies, whenever possible in the context of a multidisciplinary team, is likewise important, balancing the potential intrusiveness of a more “medicalized” pregnancy with the advantages (including the psychological reassurance) of strict follow-up (Fig. 1).

In conclusion, the postpartum period is a window of opportunity not to be missed, to improve the health of women after preeclampsia. The program designed by Le Mans hospital is definitely headed in the right direction and we are very supportive of such efforts [5].