{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T22:40:08Z","timestamp":1715812808740},"reference-count":26,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,10,23]]},"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We asked whether 60 compared with 240\u2005min observation is sufficiently informative and safe for pregnancy day assessment (PDAC) of suspected pre-eclampsia (PE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective study of 209 pregnant women (475 PDAC assessments, 6\u2005months) with routinely collected blood pressure (BP), symptom and laboratory information. We proposed a 60\u2005min screening algorithm comprising: absence of symptoms, normal laboratory parameters and \u22641high-BP reading (systolic blood pressure, SBP 140\u2005mm\u2005Hg or higher or diastolic blood pressure, DBP 90\u2005mm\u2005Hg or higher). We also evaluated two less inclusive screening algorithms. We determined short-term outcomes (within 4\u2005h): severe hypertension, proteinuric hypertension and pregnancy-induced hypertension, as well as long-term outcome: PE-related diagnoses up to the early puerperium. We assessed performance of alternate screening algorithms performance using 2\u00d72 tables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>1 in 3 women met all screen negative criteria at 1\u2005h. Their risk of hypertension requiring treatment in the next 3\u2005h was 1.8% and of failing to diagnose proteinuric hypertensive PE at 4\u2005h was 5.1%. If BP triggers were 5\u2005mm\u2005Hg lower, 1 in 6 women would be screen-negative of whom 1.1% subsequently develops treatment-requiring hypertension and 4.5% demonstrate short-term proteinuric hypertension. We present sensitivity, specificity, negative and positive likelihood ratios for alternate screening algorithms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We endorse further research into the safest screening test where women are considered for discharge after 60\u2005min. Safety, patient and staff satisfaction should be assessed prospectively. Any screening test should be used in conjunction with good clinical care to minimise maternal and perinatal hazards of PE.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009492","type":"journal-article","created":{"date-parts":[[2015,11,19]],"date-time":"2015-11-19T02:54:11Z","timestamp":1447901651000},"page":"e009492","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness and safety of 1 vs 4\u2005h blood pressure profile with clinical and laboratory assessment for the exclusion of gestational hypertension and pre-eclampsia: a retrospective study in a university affiliated maternity hospital"],"prefix":"10.1136","volume":"5","author":[{"given":"Elizabeth Anne","family":"McCarthy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A","family":"Carins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"Hannigan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Bardien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"Shub","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan P","family":"Walker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,11,18]]},"reference":[{"key":"2024051514523063000_5.11.e009492.1","first-page":"24","article-title":"Recent advances in the diagnosis and management of pre-eclampsia","volume":"7","author":"Duhig","year":"2015","journal-title":"F1000Prime Rep"},{"key":"2024051514523063000_5.11.e009492.2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2660"},{"key":"2024051514523063000_5.11.e009492.3","doi-asserted-by":"crossref","unstructured":"Dowswell T , Middleton P , Weeks A . 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