title: Could oedema and proteinuria in pregnancy be used to screen for high risk? The WHO International Collaborative Study of Hypertensive Disorders of Pregnancy.
abstract: Prospectively gathered data from eight geographically defined areas in south-east Asia included serial measures of blood pressure, proteinuria and oedema during pregnancy. A total of 15,476 pregnancies were included. Both antenatal oedema and proteinuria were markers of increased risk of antenatal diastolic hypertension, proteinuric pre-eclampsia and eclampsia. However they identified fetuses at high risk of low birthweight and perinatal mortality only in areas where the incidence of hypertension was low. As a screening strategy to identify women who are at increased risk of antenatal diastolic hypertension, of proteinuric pre-eclampsia and of eclampsia, the most efficient strategy is probably to use the presence of oedema and/or proteinuria. The sensitivity of using this method for identifying women with proteinuric pre-eclampsia is high, but for identifying eclampsia it is still relatively low. Where resources are available there is probably no substitute for using a sphygmomanometer and measuring blood pressure.
mesh_terms: D001210:Asia, Southeastern; D004461:Eclampsia / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008403:Mass Screening; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors