Objective: To examine the extent to which recommendations in the proposed guidelines for hypertension in pregnancy by The Indonesian Society of Obstetrics and Gynecology (ISOG) are based on evidence from systematic reviews of controlled trials.

Design: Retrospective analysis of recommendations for the ISOG guidelines for hypertension in pregnancy.

Materials: ISOG guidelines in clinical practice on hypertension in pregnancy.

Main outcome measures: The type of evidence (systematic review of controlled trials, individual trials, other studies, expert opinion) used to support each recommendation. The author also assessed whether a Cochrane systematic review was available and could have been used in formulating the recommendation.

Results: An explicit and sensible process to identify, select, and combine evidence was not used. To support its recommendation, the guideline used mostly textbook (58.3%, range of year of publication 1952-2004), journal articles (25%, only 2 randomized controlled trials), and others' clinical practice guideline (16.7%, mostly consensus-based). Cochrane systematic reviews could have been used to develop many of the recommendations but were actually not used.

Conclusion: Cochrane systematic reviews were not used in the development of clinical practice guidelines on hypertension in pregnancy by The Indonesian Society of Obstetrics and Gynecology. In part this may be due to still very limited availability and accessibility of Cochrane systematic reviews in Indonesia. A strategic plan to increase the availability and accessibility of Cochrane systematic reviews in Indonesia is urgently needed to improve the quality of clinical practice guidelines developed by health professional organizations.