-
Views
-
Cite
Cite
D. E. Ayala, R. C. Hermida, A. Mojón, J. R. Fernández, I. Alonso, P-17: Predictable blood pressure changes along gestation in healthy and complicated pregnancies, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 35A, https://doi.org/10.1016/S0895-7061(01)01495-9
Close - Share Icon Share
Abstract
Previous studies have shown differences in the predictable trends of lood pressure (BP) along gestation between healthy and complicated pregnancies [Ayala et al. Hypertension 1997;30(3):611-618]. In the attempt to corroborate and extend those conclusions, we quantified changes in BP and heart rlate (HR) with gestational age in pregnant women studied by ambulatory BP monitoring (ABPM) throughout pregnancy. We analyzed 1404 BP series sampled from 234 healthy pregnant women and 1017 series from 167 women who developed gestational hypertension or preeclampsia. BP was measured every 20 minutes during the day and every 30 minutes during the night for 48 hours with an ambulatory device once every 4 weeks from the first visit to the hospital (usually before 14 weeks of gestation) until delivery. The pattern of variation along gestation of the 24-hour mean of BP and HR was established by polynomial regression analysis. For normotensive women, results indicate a steady decrease in BP up to 20 weeks of pregnancy, followed by an increase in BP up to delivery (P<0.001), with an average 7% BP increase between the end of the first trimester (14 weeks of gestation) and delivery. In complicated pregnancies, BP is stable until 22 weeks of gestation, and then increases linearly for the remaining of pregnancy (correlation coefficient r=.456, P<0.001, for systolic BP; r=.482, P<0.001, for diastolic BP). This group showed an average increase of ~11% in BP between 14 weeks of gestation and delivery. For both healthy and complicated pregnancies, HR slightly increases until the end of the second trimester, and it is stable thereafter. This study on women systematically sampled by 48-hour ABPM throughout gestation confirms the predictable pregnancy-associated variability in BP and provides proper information for the establishment of reference limits for BP to be used in the early diagnosis of hypertensive complications in pregnancy. Those limits should be developed as a function of gestational age, taking into account the trends in BP dynamics throughout pregnancy here demonstrated.
