[Methods for the early recognition of gestosis].

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Diagnostics

Context:

• Preeclampsia, a severe form of gestosis, poses significant risks to maternal and fetal well-being.
• Early recognition and prediction of hypertensive disorders in pregnancy are crucial for improving outcomes.
• Current screening methods have limitations regarding accuracy and practicality.

Purpose:

• To evaluate the effectiveness of the supine pressor test (roll-over test) for routine screening of preeclampsia in primigravid pregnancies.
• To compare the diagnostic performance of the roll-over test and the angiotensin sensitivity test.
• To assess the utility of serum uric acid concentration in predicting pregnancy-induced hypertension.

Summary:

• The supine pressor test is a recommended, simple screening method for preeclampsia with a low false-negative rate, though it can yield false-positive results.
• The angiotensin sensitivity test demonstrates fewer false-positive pressor responses but is not practical for routine screening.
• Routine serum uric acid determination has limited value for predicting pregnancy-induced hypertension but aids in diagnosing questionable gestosis and differentiating hypertension types.

Impact:

• Implementing the roll-over test can lead to earlier identification of preeclampsia, potentially reducing severe forms of the disease.
• Improved prediction of hypertensive disorders of pregnancy is expected to lower maternal and infantile perinatal mortality rates.
• This research provides insights into optimizing diagnostic strategies for hypertensive disorders during pregnancy.