1308 Letters
April 1992
Am
sia." Unfortunately, Ales is not an obstetrician, and thus she continues to equate the word "hypertension" with preeclampsia. This was true about 10 years ago; however, recent evidence indicates that there is more to preeclampsia than hypertension. Ales' cited work involves using 0: reading at ::;20 weeks' gestation as a screening for second-trimester MAP. I In contrast, most data in the literature use the average readings of several values obtained during the second trimester. Her data would have been included if the title of our review was "Early Detection of Hypertensive Disorders of Pregnancy" rather than preeclampsia. Indeed, her prospective study was originally included but had to be deleted because it does not apply to preeclampsia. Fortunately, the original critique of her study was still in the original long manuscript and will thus be set forth here: A recent prospective study by Ales et al. I evaluated the predictive value of one MAP recording at 20 weeks' gestation in 730 women. The authors found a MAP value of ~85 mm Hg to be clinically significant in predicting antepartum hypertension. Of the 139 women with a MAP ~85 mm Hg, 21.6% had subsequent antepartum hypertension as compared with a frequency of 0.7% among the women who had a value of
April 1992
Am
sia." Unfortunately, Ales is not an obstetrician, and thus she continues to equate the word "hypertension" with preeclampsia. This was true about 10 years ago; however, recent evidence indicates that there is more to preeclampsia than hypertension. Ales' cited work involves using 0: reading at ::;20 weeks' gestation as a screening for second-trimester MAP. I In contrast, most data in the literature use the average readings of several values obtained during the second trimester. Her data would have been included if the title of our review was "Early Detection of Hypertensive Disorders of Pregnancy" rather than preeclampsia. Indeed, her prospective study was originally included but had to be deleted because it does not apply to preeclampsia. Fortunately, the original critique of her study was still in the original long manuscript and will thus be set forth here: A recent prospective study by Ales et al. I evaluated the predictive value of one MAP recording at 20 weeks' gestation in 730 women. The authors found a MAP value of ~85 mm Hg to be clinically significant in predicting antepartum hypertension. Of the 139 women with a MAP ~85 mm Hg, 21.6% had subsequent antepartum hypertension as compared with a frequency of 0.7% among the women who had a value of
