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[Profile dipper/non-dipper in patient with severe preeclampsia, eclampsia and HELLP syndrome during pregnancy and
Insights
Patients with severe preeclampsia, eclampsia, and HELLP syndrome exhibit a "no dipper" blood pressure profile during pregnancy and postpartum. This abnormal circadian rhythm did not change with standard treatment, highlighting the need for new strategies.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Critical Care Medicine
Background:
- Blood pressure (BP) exhibits a circadian rhythm, with normal
- dipper
- profiles showing lower nighttime BP.
- Deviations, such as the
- no dipper
- profile (elevated nighttime BP), are linked to increased cardiovascular risk.
- Preeclampsia-eclampsia, a condition affecting ~7% of pregnancies, is known to disrupt normal BP circadian patterns.
Purpose of the Study:
- To investigate the prevalence of
- dipper
- and
- no dipper
- blood pressure profiles in patients with severe preeclampsia, eclampsia, and HELLP syndrome.
Main Methods:
- Analysis of 15 patients (10 severe preeclampsia, 4 HELLP syndrome, 1 eclampsia) in intensive care.
- Evaluation of systolic, diastolic, mean, and pulse BP during day/night cycles in pregnancy and postpartum.
- Determination of
- dipper
- /
- no dipper
- status using BP ratios (day/night) during pregnancy and postpartum.
Main Results:
- The study included maternal ages of 30 ± 6.34 years, with 46% primiparous and 54% multiparous patients.
- Pregnancy occurred at 31.67 ± 4.59 weeks gestation.
- The
- no dipper
- profile was consistently observed in nearly all patients during pregnancy, with no significant changes noted in the postpartum period.
Conclusions:
- All patients with severe preeclampsia, eclampsia, and HELLP syndrome demonstrated a
- no dipper
- blood pressure profile throughout pregnancy and postpartum.
- Current therapeutic interventions did not alter this abnormal circadian BP pattern.
- Developing strategies to restore normal circadian BP rhythm in these high-risk patients is crucial.
Background:
Blood pressure (BP) has a circadian rhythm, decreases at night and increases in the morning (dipper), have been observed in patients with impaired in this profile, increased at night and lower in the morning (no dipper) have increased cardiovascular risk. Preeclampsia-eclampsia complicates about 7% of pregnancies, preeclampsia is known to reverse the normal circadian cycle of the BP.
Objective:
To determine the profile dipper/non-dipper in patients with severe preeclampsia, eclampsia and HELLP syndrome patients in Intensive Care and Obstetrics Hospital Juárez of México.
Material And Methods:
15 patients were reviewed, 10 with severe preeclampsia, 4 with HELLP syndrome and 1 eclampsia, systolic, diastolic, mean and pulse PA were analyzed during the day/night and pregnancy/postpartum. Using ratios pregnancy day/night pregnancy, puerperium day/night postpartum dipper/non-dipper profile is determined
Results:
Maternal age 30 ± 6.34 years, 7 primiparous (46%) 8 multiparous (54%), pregnancy was 31.67 ± 4.59 weeks. In all but two results in the ratio of pulse pressure during pregnancy was not the result dipper raiser and did not change during the postpartum period.
Conclusion:
in all patients during pregnancy profile was observed no dipper no change during the postpartum period. The established treatment did not modify this result. So it is appropriate to establish strategies to change this behavior and try to get the patient to regain normal circadian BP rhythm.
