Redman C W, Jefferies M
Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford.
Lancet. 1988 Apr 9;1(8589):809-12. doi: 10.1016/s0140-6736(88)91667-4.
Different measures of raised blood pressure were analysed in 16,211 singleton pregnancies to determine the most effective way of identifying pre-eclampsia. Increments from baseline in the first half of pregnancy were considered as well as absolute levels. A combination of a high maximum diastolic pressure with a large increase from baseline was better for identifying a group with pre-eclamptic features than either measurement on its own. A first diastolic pressure below 90 mm Hg, a subsequent increase of at least 25 mm Hg, and a maximum reading of at least 90 mm Hg gave appropriate criteria. These were applied to a second set of 15,624 singleton pregnancies and successfully identified a group with pre-eclamptic features. Fewer women were identified as pre-eclamptic than with criteria modified from an existing definition widely used in Britain. The women excluded by the new criteria had the features of mild chronic hypertension rather than pre-eclampsia. The new definition is simple to use but like all other definitions of pre-eclampsia cannot be precise.
对16211例单胎妊娠的不同血压升高测量值进行分析，以确定识别先兆子痫的最有效方法。研究考虑了妊娠前半期相对于基线的血压增量以及绝对血压水平。与单独使用任何一种测量方法相比，最大舒张压高且相对于基线有大幅升高的组合，对于识别具有先兆子痫特征的人群更有效。首次舒张压低于90 mmHg、随后至少升高25 mmHg以及最高读数至少为90 mmHg给出了合适的标准。将这些标准应用于另一组15624例单胎妊娠，成功识别出具有先兆子痫特征的人群。与采用英国广泛使用的现有定义修改后的标准相比，被识别为先兆子痫的女性更少。被新标准排除的女性具有轻度慢性高血压的特征，而非先兆子痫。新定义使用简便，但与先兆子痫的所有其他定义一样，无法做到精确无误。
