Intended for healthcare professionals


Pre-eclampsia matters

BMJ 2005; 330 doi: (Published 10 March 2005) Cite this as: BMJ 2005;330:549
  1. Ian A Greer (, Regius professor of obstetrics and gynaecology
  1. University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER

New guideline is simple, evidence based, and clinical, and should be used

Pre-eclampsia matters. In both the developed and the developing world, pre-eclampsia is important. It remains a leading cause of maternal and perinatal mortality and extensive morbidity. The reports of the Confidential Enquiry Into Maternal Deaths1 have identified deficiencies in care in relation to pre-eclampsia in successive reports since the 1950s. In this issue, the systematic review by Duckitt and Harrington quantifies the risk of pre-eclampsia associated with different factors present at the antenatal booking visit (p 565).2 The rationale is that this risk assessment will inform allocation of the woman to a suitable surveillance routine to detect pre-eclampsia.

The risk of pre-eclampsia is increased with a previous history of pre-eclampsia, pre-existing diabetes, multiple pregnancy, a family history for pre-eclampsia, a raised body mass index before pregnancy or at booking, raised blood pressure at booking, and the presence of anti-phospholipid antibodies. These risk factors are important, with relative risks of almost threefold for nulliparity and over ninefold for antiphospholipid antibodies. With a background incidence of 2-3%, this translates to absolute risks …

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