Key result
24-h diastolic blood pressure mean at 20 weeks' gestation was significantly higher in women who developed idiopathic IUGR (69.2 mmHg) or PIH (73.5 mmHg) compared to controls (62.2 mmHg).
Why the study?
Does 24-h ambulatory blood pressure monitoring at 20 weeks' gestation predict the development of gestational hypertension or IUGR in normotensive nulliparous women?
Cohort (n=334)
Does 24-h ambulatory blood pressure monitoring at 20 weeks' gestation predict the development of gestational hypertension or IUGR in normotensive nulliparous women?
Mid-trimester 24-h ABPM can reliably predict the development of idiopathic IUGR and pregnancy-induced hypertension in initially normotensive nulliparous women.
Hypothesis-generating for ambulatory BP monitoring in pregnancy; leaves open predictive utility pending validation.
OBJECTIVES: To investigate clinical impact of 24-h ambulatory blood pressure monitoring (ABPM) on the prediction of hypertensive disorders of pregnancy and IUGR. METHODS: ABPM was performed in 334 normotensive non-proteinuric nulliparous women at 20 weeks' gestation. Arterial blood pressure patterns were analyzed by chronobiometry. RESULTS: Women who developed idiopathic IUGR (21) or PIH (33) showed a 24-h diastolic blood pressure mean significantly higher than the controls (69.2+/-1.8 mmHg and 73.5+/-6.2 vs. 62.2+/-1.5). Women with subsequent IUGR also showed a modification in BP rhythm. The most effective cut-off levels of 24-h diastolic blood pressure mean proved to be 67 for IUGR and 68 for hypertension. CONCLUSIONS: ABPM in the second trimester reliably predicts idiopathic IUGR and PIH. Both patients destined to develop gestational hypertension and those destined to develop IUGR show similar elevations in 24-h diastolic mean at 20 weeks' gestation.
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Tranquilli et al. (2003) conducted a cohort in Pregnancy (n=334). 24-h ambulatory blood pressure monitoring (ABPM) vs. Controls (normal pregnancy outcome) was evaluated on 24-h diastolic blood pressure mean. 24-h diastolic blood pressure mean at 20 weeks' gestation was significantly higher in women who developed idiopathic IUGR (69.2 mmHg) or PIH (73.5 mmHg) compared to controls (62.2 mmHg).
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