We thank Drs Katie, da'Silva Costa and- Brennecke on their excellent summary of early pregnancy strategies for predicting pre-eclampsia. As the authors of the shortly-to-be-updated SOMANZ Guidelines for Management of Hypertensive Diseases of Pregnancy, we agree that accurate and early prediction of this disorder may help monitor and focus management of this group of women. Screening tests must be relevant for the full spectrum of women with pre-eclampsia, including not only those presenting with hypertension and proteinuria but the 26% manifesting primarily as hypertension with another multisystem complication. The danger of the endpoint being hypertension and proteinuria only is that the test will not capture the group of women with pre-eclampsia at risk of significant morbidity. Furthermore, the heterogeneous nature of late onset disease limits the ability to accurately predict these women in early pregnancy.
展开▼
