A wee break for pregnant women
EMBARGOED UNTIL 12 NOON SUNDAY 3 NOVEMBER 2002
Regular urine testing during pregnancy should be a thing of the past for most women, according to research published in the latest edition of the Medical Journal of Australia.
Research by Dr Caroline SE Homer, and colleagues from St George Hospital, University of NSW and University of Technology Sydney, Ms Noreen Murray, Dr Gregory Davis, Ms Julie Curtis, Dr Gerorge Mangos and Professor Mark Brown, showed that regular urine testing during pregnancy is a poor predicator of the onset of pre-eclampsia (previously called toxaemia of pregnancy).
"All pregnant women at low-risk of pre-eclampsia should provide a midstream urine sample at their first antenatal visit for an automated dipstick urine test," Dr Homer says.
"After the first screening, routine urine testing could be eliminated for low risk women, unless they develop high blood pressure or signs of a urinary tract infection," she said.
"The current practice in Australia involves testing pregnant women routinely at each visit to the doctor - monthly for the first 28 weeks, fortnightly until 36 weeks, and weekly for the remainder of the pregnancy.
"Routine urine tests should continue for women with at-risk pregnancies, who include those with an early increase in blood pressure and kidney disease."
Professor Euan M Wallace and Professor Jeremy J N Oats, in an editorial in the same issue of the Journal said that, in light of the findings, providers should consider whether routine urine tests constitute the most cost-effective care.
"It is of concern that there is considerable variation in routine antenatal testing in our hospitals, and that practice is often at odds with available evidence," said Professor Wallace.
"These inconsistencies represent inequalities in care, and wastage of precious and limited resources," he said.
"National standardisation of care might reasonably be expected to reduce this wastage."
Pre-eclampsia is a complication of pregnancy characterized by the new development of hypertension after 20 weeks of pregnancy, associated with the involvement of other organs such as the kidney, liver or placenta. It is the commonest medical complication of pregnancy and may severely affect mother and baby causing convulsions, kidney failure and preterm birth of poorly grown babies in severe cases. Pre-eclampsia and its complications are responsible for a significant number of deaths for mothers and their babies.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Research, Dr Caroline S E Homer, 02 9350 3298 (B/H) 0418 466 974
(A/H) 02 9350 1111 (leave a message for pager 754)
Editorial, Euan M Wallace, 03 9594 5145 (B/H) 03 9387 1000 (A/H)
Judith Tokley, AMA Public Affairs, 0408 824 306