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Predictable blood pressure variability in healthy and complicated pregnancies
R C Hermida1, D E Ayala, M Iglesias
1Bioengineering and Chronobiology Laboratories, University of Vigo, Campus Universitario, Vigo, Spain. rhermida@tsc.uvigo.es
Hypertension (Dallas, Tex. : 1979)
|September 22, 2001
Summary
Blood pressure (BP) naturally changes during pregnancy, decreasing then increasing in healthy women. Hypertensive disorders show a distinct BP rise in the second half of gestation, aiding early diagnosis.
Area of Science:
- Obstetrics and Gynecology
- Cardiovascular Physiology
- Perinatal Medicine
Background:
- Blood pressure (BP) exhibits unique variability throughout pregnancy.
- Understanding these predictable patterns is crucial for diagnosing hypertensive disorders of pregnancy.
Purpose of the Study:
- To describe the predictable pattern of blood pressure (BP) variability during gestation.
- To establish reference limits for BP based on gestational age for early diagnosis of hypertensive complications.
Main Methods:
- Analysis of 2430 BP series from ambulatory monitoring (48 consecutive hours every 4 weeks) in 235 normotensive, 128 gestational hypertension, and 40 preeclampsia women.
- Polynomial regression analysis to establish BP and heart rate variation patterns throughout gestation for each group.
Main Results:
- Normotensive pregnancies: BP decreases until 20 weeks, then increases by 8% by delivery.
- Complicated pregnancies: BP stable until 22 weeks, then increases linearly (9% systolic, 13% diastolic in the second half).
- Preeclampsia group showed higher BP trends than gestational hypertension in the second half of pregnancy.
Conclusions:
- Confirms predictable pregnancy-associated BP variability using systematic ambulatory BP monitoring.
- Provides data for developing gestational age-specific reference limits for early diagnosis of hypertensive disorders.
- Highlights distinct BP trends in normotensive versus complicated pregnancies, aiding differential diagnosis.