Assessing the onset of pre-eclampsia in the hospital day unit: summary of the pre-eclampsia guideline (PRECOG II)

• Published in: BMJ Vol. 339; no. sep09 3; p. b3129
• Main Authors: Milne, Fiona, Redman, Chris, Walker, James, Baker, Phil, Black, Rebecca, Blincowe, Jill, Cooper, Carol, Fletcher, Gillian, Jokinen, Mervi, Moran, Paul A, Nelson-Piercy, Catherine, Robson, Stephen, Shennan, Andrew, Tuffnell, Angela, Waugh, Jason
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 09.09.2009; BMJ Publishing Group LTD
• Subjects: Age; Blood pressure; Day Care, Medical; Female; Health care policy; Humans; Hypertension; Midwifery; Pre-Eclampsia - diagnosis; Pre-Eclampsia - therapy; Preeclampsia; Pregnancy; Prenatal Care - methods; Prenatal Diagnosis - methods; Proteins; Referral and Consultation; Studies; Urine; Veins & arteries
• ISSN: 0959-8138; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.b3129

Term Definition used in guideline Fetal compromise (clinical suspicion) Reduced fetal movements, small for gestational age infant (clinically assessed) Hypertension A diastolic blood pressure of â[per thousand]¥90 mm Hg New hypertension Hypertension at or after 20 weeks' gestation in a woman with a diastolic blood pressure of <90 mm Hg before 20 weeks Pre-existing hypertension A diastolic blood pressure before pregnancy or at booking (before 20 weeks) of â[per thousand]¥90 mm Hg New proteinuria The presence of proteinuria as shown by 1+ (0.3 g/l) or higher on dipstick testing; a protein to creatinine ratio of â[per thousand]¥30 on a random sample; or a urine protein excretion of â[per thousand]¥300 mg/24 h Significant proteinuria Urine protein excretion â[per thousand]¥300 mg/24 h Pre-eclampsia New hypertension and significant proteinuria at or after 20 weeks of pregnancy, confirmed if it resolves after delivery Superimposed pre-eclampsia The development of features of pre-eclampsia in the context of pre-existing hypertension, pre-existing proteinuria, or both Box 1 Levels of evidence on which recommendations are based*[dagger] Grading of recommendations Grade A-Directly based on category I evidence Grade B-Directly based on category II evidence or extrapolated recommendation from category I evidence Grade C-Directly based on category III evidence or extrapolated recommendation from category I or II evidence Grade D-Directly based on category IV evidence or extrapolated recommendation from category I, II, or III evidence GPP (good practice point)-Based on the view of the guideline development group Grading (level) of evidence Level Ia-Evidence obtained from meta-analysis of randomised controlled trials Level Ib-Evidence obtained from at least one randomised controlled trial Level IIa-Evidence obtained from at least one well designed, controlled study without randomisation.