[Methods for the early recognition of gestosis].

The frequency of the severe forms of gestosis (preeclampsia) may be reduced by early recognition of this disease. By predicting hypertensive disorders of pregnancy, maternal and infantile perinatal mortality rates are expected to be lowered. The supine pressor test ("roll-over test") is recommended as an appropriate and simple method for routine screening during primigravid pregnancy. This test is rarely false-negative (2--9%; Bonn 3%), but a high percentage of false-positive results has been found in patients studied in Bonn. The angiotensin sensitivity test shows less false-positive pressor responses, but it is not practical for routine use either as infusion test nor as bolus test. The rate of false-negative results is sufficiently low in both methods. The routine determination of uric acid concentration in serum seems to be of no great value for predicting pregnancy-induced hypertension, compared with the roll-over test or with the angiotensin sensitivity test; however, it gives an additional information (a) in pregnancy women with questionable gestosis, and (b) in the differential diagnosis of pregnancy-induced versus pre-existing essential hypertension.