The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the Editor
Editor, – I read with interest the article on biochemical tests in pregnancy (Aust Prescr 2006;29:48-52) and wish to comment on the discussion of pre-eclampsia. The author maintains that the diagnosis is based on a triad of hypertension, proteinuria and oedema, yet the Australasian Society for the Study of Hypertension in Pregnancy has issued a consensus statement which asserts otherwise.1 While hypertension is a requirement, proteinuria (as one of a range of possible end organ effects) is not mandatory to make the diagnosis. Oedema is specifically excluded unless its onset is rapid and generalised. This is important to appreciate as severe forms of pre-eclampsia (and indeed eclampsia) can occur in the absence of the 'triad'. Furthermore, 'routine' urinalysis at each visit in low-risk pregnancies has been discontinued in many centres due to its limited value.
Mount Gambier, SA
- Brown MA, Hague WM, Higgins J, Lowe S, Mc Cowan L, Oats J, et al. Australasian Society for the Study of Hypertension in Pregnancy. The detection, investigation and management of hypertension in pregnancy: full consensus statement. Aust N Z J Obstet Gynaecol 2000;40:139-55.
- Raz R. Asymptomatic bacteriuria - clinical significance and management. Nephrol Dial Transplant 2001;16 (Suppl 6):135-6.
- Crowther CA, Hiller JE, Moss JR, Mc Phee AJ, Jeffries WS, Robinson JS. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005;352:2477-86.
- Antenatal care: Routine care for the healthy pregnant woman. London: National Collaborating Centre for Women's and Children's Health; 2003. http://www.rcog.org.uk/resources/Public/pdf/Antenatal_Care.pdf [cited 2006 Jul 4]