The diversity of diagnoses of preeclampsia

Objective. To document the diversity of definitions and diagnoses of the hy pertensive disorders of pregnancy reported in major medical journals as a p reliminary step from which future documents may be developed concerning the classification and diagnosis of the hypertensive disorders of pregnancy. Methods. A systematic review was undertaken of articles published between 1 997 and 1998 researching "preeclampsia" in nine internationally recognized journals. Each article was assessed to establish the features used by the a uthors to define preeclampsia and its major defining variables (i.e., prote inuria and hypertension). Documentation of aspects of the blood pressure me asurement technique was also noted. Results. One hundred thirty-five articles were studied, demonstrating a wid e variety in the authors' definitions of preeclampsia, "significant" protei nuria, and hypertension. In up to 13% of articles, one or more of these ter ms was not defined and documentation of the blood pressure measurement tech nique was generally poor. The diversity of reporting was of such magnitude that the groups of women in these studies could rarely be considered truly comparable. Conclusion. Scientific and clinical research groups are studying different preeclamptic groups as a result of using different definitions of this cond ition. As comparison of results among studies is fundamental to the correct elucidation of knowledge about preeclampsia, standardization of the classi fication and diagnostic criteria of the hypertensive disorders of pregnancy should be a major priority of societies devoted to the study of these diso rders.