[Relation of maternal mean arterial pressure and fetal growth course to the onset of preeclampsia in second trimester].

Severe preeclampsia in the second trimester presents a major challenge in management because it is associated with high perinatal mortality. One possible way to improve the perinatal outcome in these pregnancies is to predict the later development of preeclampsia and to start management of it early. To investigate the relationship between the timing of the rise in maternal mean arterial pressure (MAP) and the course of biparietal diameter (BPD) growth in the fetus, we reviewed seven women with preeclampsia diagnosed between 18 and 27 weeks' gestation. MAP increased slowly within the normal range three or four weeks before the onset of the disease. Slowing of the fetal BPD growth curve preceded the onset of preeclampsia by two to four weeks. Serial measurement of BPD from early pregnancy may prevent the onset of severe preeclampsia before 28 weeks' gestation.