Intended for healthcare professionals

Rapid response to:

Primary Care

The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community

BMJ 2005; 330 doi: (Published 10 March 2005) Cite this as: BMJ 2005;330:576

Rapid Response:

Antiphospholipid testing and Systolic BP levels

As a GP I would like to raise two issues about the guidelines.

It is suggested that in the initial assessment the presence of antiphospholipid antibodies should prompt referral for specialist assessment. It is not clear if it is being suggested that we merely take it into account if it is already known to be present or if we should be actively testing for its presence. If the intention is for the testing to be done in primary care I would have liked guidance on which tests to perform and when to repeat them as my understanding that there is no single diagnostic test and that transient +ve results are common.

My second question is in regards to table 2. The implication is that in the absence of proteinuria and with a diastolic <_90 mm="mm" hg="hg" a="a" systolic="systolic" of="of" _160="_160" or="or" above="above" should="should" lead="lead" to="to" referral="referral" for="for" same="same" day="day" hospital="hospital" assessment="assessment" but="but" in="in" the="the" presence="presence" proteinuria="proteinuria" one="one" would="would" only="only" need="need" take="take" action="action" if="if" was="was" greater="greater" that="that" _170="_170" assuming="assuming" diastolic="diastolic" _90="_90" hg.="hg." this="this" seems="seems" counterintuitive="counterintuitive" and="and" i="i" wonder="wonder" it="it" is="is" misprint.="misprint." p="p"/>Competing interests: None declared

Competing interests: No competing interests

16 March 2005
Steven M Charkin
St Johns Wood Medical Practice, 22 St Anns Terrace, London NW8 6PJ